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The Checklist of Understanding (COU) is a form new CHM members receive with their welcome packet that must be completed and returned to CHM as quickly as possible. The COU is a legal document stating you understand that CHM is a voluntary cost-sharing ministry and not a health insurance company. The COU must be on file with Christian Healthcare Ministries before we can share your medical needs; it corrects insurance regulators who may incorrectly assume that CHM members do not understand the difference between voluntary health cost-sharing and health insurance.
An illness is a diagnosis of a disease, injury or medical condition that has been identified and can be treated once or multiple times (multiple incidents). CHM sharing limits are determined by illness. Members can receive up to $125,000 per illness in the regular sharing program and up to $1 million or more per illness by participating in the Brother’s Keeper program.
Example 1: Diabetes is an illness that can be treated at a maintenance level but can flare up and create an incident. The incident (medical bills related to the flare-up) has a definite start and end date; the illness can last a lifetime.
Example 2: Your knee hurts so you go to the doctor, who orders an MRI. After viewing your test results, he diagnoses you with arthritis. He gives you a cortisone shot and your knee soon feels better. The diagnosis of arthritis in your knee is an illness. The medical examinations, testing and treatment you undergo is an incident. Two years later, your knee starts to hurt again. You return to the doctor, who says your arthritis has flared up. He gives you another cortisone shot. After two weeks, you go back because it still hurts. He tells you that you need a knee replacement and schedules the surgery. You undergo surgery and physical therapy. After a few months, he gives you a clean bill of health. This scenario describes a second incident within the illness of arthritis in your knee.
An incident includes medical treatment or testing that lasts until one of the following events occurs:
1) a certain medical condition is cured according to official medical records;
2) treatment is at a routine maintenance level; or
3) you experience 90 days without any kind of treatment for that particular condition (testing or treatment must be an eligible expense at your chosen level of participation: Gold, Silver, or Bronze).
The medical bills incurred from the first test to the last treatment before the doctor releases you to a regular, routine maintenance regimen are considered a single incident. If 90 days pass and you receive no further treatment, any future bills you incur will be considered a separate incident. Personal responsibility amounts for the Silver and Bronze participation levels are per incident (for info about the Gold level, see our Programs page).
Example: You go to the doctor due to pain in your side. He examines you and gives you some instructions before sending you home. The next week you return because the pain has continued. The doctor orders a blood test and an ultrasound. After reviewing the results, he diagnoses you with appendicitis and sends you to the hospital. He performs an appendectomy. The hospital releases you with instructions to visit the doctor’s office in one week for follow-up. At that visit the doctor tells you come back again the following week, at which time he pronounces you cured. Medical bills you incur for each of these situations fall under the category of a single incident.
The Member Gift Form (MGF) is a monthly billing statement notifying you that your financial gift amount is due. Along with your membership account statement, the Member Gift Form includes a ministry update letter each month. Reading the letter keeps you informed on ministry policies, activities and events. If you’re a member who wishes to receive the MGF by email rather than mail, click here.
A need is an individual medical bill. It’s often necessary for CHM members and staff to distinguish between individual medical bills. A need is categorized under a particular incident, which falls under a certain illness/diagnosis.
Personal Responsibility is the amount CHM members are responsible to pay for a medical event and is $1,000 and $5,000 per medical incident for Silver and Bronze members, respectively. (Bill discounts, health insurance, Medicare, or other assistance can apply toward your Personal Responsibility amount and reduce out-of-pocket costs. This feature is unique to CHM.) Gold members: CHM shares 100 percent of bills for any medical incident exceeding $500 as long as all other Guidelines are met. (Total bills incurred per incident must exceed $500 in order to be eligible for sharing.) All CHM members: Members are responsible to pay incidental medical expenses, such as maintenance prescriptions, dental expenses, etc. (see our prescriptions and dental and vision pages for more info). Bill discounts, insurance, Medicare payments or other assistance can apply toward your personal responsibility amount and reduce out-of-pocket costs. This feature is unique to CHM.
A pre-existing condition is any medical illness with signs, symptoms, testing or treatment predating membership in Christian Healthcare Ministries (even if it has not been diagnosed). CHM has cost-sharing programs for bills from pre-existing conditions.
A reduction is a discount given by a healthcare provider. CHM members are technically self-pay patients and often qualify for discounts on their medical bills. Discounts represent about 40 percent of all medical bills submitted to CHM; without them, CHM monthly financial gifts could be more than twice as high. Please don't be shy about asking for a discount. To learn more, see our Provider Interaction page.
Sharing occurs when CHM sends funds (members’ monthly financial gifts and extra gifts) to members whose medical bills are eligible according to the CHM Guidelines, or when the ministry reimburses members who paid for eligible medical needs out-of-pocket. We take care to make sure our members understand that CHM is not insurance and does not assume the legal obligation to pay your medical bills. Your fellow members voluntarily share your medical bills and you use that money to pay your bills. Since 1981, CHM members have faithfully given money each month to share each other’s medical expenses.
There are three programs from which members can choose: Gold ($150 per unit, per month), Silver ($85 per unit, per month) and Bronze ($45 per unit, per month). The dollar amounts are called monthly financial gifts and are required for medical bill sharing eligibility. Medical bills are approved for sharing based on the CHM Guidelines and the member’s sharing level. Switching levels affects the amount and type of medical bills eligible for sharing.
Bills are submitted to CHM via U.S. mail, fax, or online via the Member Portal (we discourage the use of email since it isn’t a secure means of transmission. If submitting by mail, be sure to keep personal copies of your bills.) A complete guide to submitting bills is available by clicking here. CHM isn’t an insurance company and cannot be billed by health care providers. Members must be billed directly, after which members must send the itemized bills to the ministry within six months of the date of service. The faster bills are submitted to the CHM office, the faster they can be presented for sharing among CHM members. Bills are shared based on when they are received by the CHM office, not on when they are incurred.
A unit is one qualifying individual. Two units are two qualifying immediate family members; three units are three or more qualifying immediate family members. No family’s monthly financial gift exceeds three units, regardless of the number of immediate family members. The number of units determines monthly financial gift and Personal Responsibility amounts.