CHM and Medicare

Many members use CHM as a complement to Medicare. If you’re Medicare age, you must have parts A and B.

Medicare age CHM members participate in one of the ministry’s cost-sharing programs (Gold, Silver, or Bronze). Whichever program you choose, Christian Healthcare Ministries is always secondary to other payment sources, which means financial provision through Medicare must be exhausted before CHM members can share your medical bills.

Out-of-pocket expenses: The amount Medicare pays for any eligible medical incident applies toward your personal responsibility amount (Silver: $1,000 per incident; Bronze: $5,000 per incident).

Gold program

Gold level membership does not include expenses from routine doctor visits, maintenance prescriptions or medical treatment below $500 retail (before any discounts are applied). To learn what types of expenses are eligible for sharing at the Gold level, visit our programs page.

Silver and Bronze programs 

Silver and Bronze do not include expenses from any doctor visits, prescriptions or hospital treatment below $1,000 retail (Silver) or $5,000 retail (Bronze). To learn what types of expenses are eligible for sharing at the Silver and Bronze levels, visit our programs page.

 

CHM and Medicare frequently asked questions

What is Medicare and who is eligible?

Medicare is the federal health insurance program primarily for people age 65 or older. Some younger individuals with disabilities and people with kidney failure may also qualify. Medicare offers varying levels of participation, including Parts A, B, C and D.

What are Medicare Parts A and B?

Medicare Part A includes facility charges from inpatient hospital stays, limited care in a skilled nursing facility, limited hospice care and some home healthcare. Medicare Part B covers certain doctors’ services (including charges incurred in the hospital), some medical equipment and preventive services. The CHM Guidelines state that members of Medicare-eligible age must have Parts A and B to receive full sharing eligibility. For more information on how you might be eligible for reduced Medicare costs, visit medicare.gov, view the “Your Medicare Costs” menu and click the links for “Part A costs” and “Part B costs.” Please note: CHM staff are not experts in what Medicare does and doesn’t cover. Please visit medicare.gov to make sure you understand exactly what’s covered by Medicare Parts A and B.

What are the differences between Medicare and a Medicare Advantage Plan (Part C)?

Also known as Medicare part C, a Medicare Advantage Plan is a type of Medicare health plan offered by a private company. By contracting with Medicare, this type of plan provides individuals with all Part A and B benefits.

How does Medicare Part C relate to CHM?

CHM is still secondary to the payment made by your Advantage Plan.

Should I join Medicare Part D for prescriptions?

The decision to join Medicare part D is yours to make; be aware that you will be penalized if you don’t get Part D coverage in a timely manner. Medicare Prescription Drug Plans (Part D) may be helpful to CHM members who take multiple routine medications. Part D may not be necessary if you have a Medicare Advantage Plan because some of them include Part D (check your plan to learn more). At the CHM Gold level, incident-related (related to the major medical test or procedure performed) prescription costs are eligible for sharing. However, it’s important to keep in mind that CHM does not share costs from routine, maintenance prescriptions at any membership level (Gold, Silver or Bronze).

Where can I get more information about Medicare?

The Medicare Helpful Contacts page is for individuals seeking more information about Medicare, including where to find local contact information and program details.

Is it common to use CHM as a complement to Medicare?

Yes, there are thousands of members who participate in both Medicare and CHM.

Why should I be a CHM member while I’m on Medicare?

As healthcare costs increase, it’s wise to be ready if a medical event occurs. Though Medicare Parts A and B likely will cover the majority of your healthcare costs, it’s not uncommon for senior citizens to find themselves with large dollar amounts of unpaid medical bills. As a CHM member, you can be confident that the ministry will share the remaining amount of your eligible bills according to the ministry’s Guidelines.

Why do I have to go on Medicare? Why can’t I join or continue with CHM only?

CHM is always secondary to other payment sources, which means financial provision through all other sources must be used before CHM members can share your medical bills. CHM requires members—of any age—to apply for financial assistance in order to help reduce overall costs and keep membership affordable. When financial gift amounts are low, more believers can afford to join CHM.

What are the advantages of CHM as a complement to Medicare?
  • Your monthly financial gift never increases because of your age or medical conditions
  • One free month for each new family you bring to CHM
  • No application or annual fee (there is a $40 annual fee per membership in Brother’s Keeper)
  • No physical required
  • The joy that comes from knowing that each financial gift goes to help a fellow Christian in need—and knowing that other Christians are faithfully standing by to help you! (Luke 6:38)
Will CHM ever create a program specifically for people on Medicare?

CHM has evaluated adding a program specifically for members of Medicare age. However, the Gold program ($150 per person, per month) is comparable to the cost of Medicare supplements and works very well for Medicare-participating members.

What CHM program works best with Medicare?

CHM doesn’t have a program specific to Medicare-age members. Membership at the Gold level combined with Brother’s Keeper is the best option for members of all ages. The Gold program offers the highest level of cost support and helps with medical bills incurred from inpatient or outpatient hospital incidents and surgery; medical testing;  physical therapy and home healthcare (up to 45 visits per illness); incident-related doctor’s office visits; and incident-related prescriptions. CHM shares up to $125,000 per illness for any of the health issues mentioned above. Adding Brother’s Keeper to your Gold program means that there’s no limit to the dollar amount of bills eligible for sharing through CHM. Silver and Bronze, though good programs, can only share medical bills incurred in a hospital (the Personal Responsibility amounts for Silver and Bronze are $1,000 and $5,000 per incident, respectively).

How does the CHM Gold program work with Medicare?

1. Medicare Parts A and B pay their portion of your qualifying medical charges and send you a Medicare Summary Notice. Please note: if you choose to go to a provider who does not accept Medicare, CHM can only share 20 percent of your eligible medical charges. For your benefit, please choose healthcare providers who accept Medicare.

2. You submit your Medicare Summary Notice—along with CHM’s sharing request packet—to the ministry.

a. If your provider gives you an additional discount, write in the discount amount and the adjusted total owed on your MSN before sending it to CHM.

b. Gold members only: Please send itemized bills for prescriptions only.

3. CHM processes your eligible charges and sends you a check to share the balance Medicare doesn’t pay.

4. You pay your provider(s) directly for any balance due.

Adding Brother’s Keeper to your Gold program means that there’s no limit to the dollar amount of bills eligible for sharing. Learn more about Brother’s Keeper costs on our programs page.

Silver and Bronze, though good programs, can only share surgery bills or medical bills incurred in a hospital. Therefore, there’s no reason to offer them to CHM members on Medicare.

If I have both Medicare and CHM, what happens when I incur medical bills?

Medicare or your Medicare Advantage Plan pays first. (CHM shares eligible medical bills after all other resources are used.) Then, instead of submitting itemized bills to CHM, submit your Medicare Summary Notice or your Medicare Advantage Plan Explanation of Benefits (EOB). The only exceptions—situations in which you’d need to send itemized bills—are prescriptions and any bills from non-Medicare participating providers. For all medical incidents, send the CHM sharing request packet (formerly called the "Needs Processing forms"). We also recommend watching our step-by-step video on how to submit medical expenses to CHM.

What about personal responsibility and out-of-pocket costs?

As always, medical bill discounts are applied to your Personal Responsibility amount, an advantage that often brings your out-of-pocket costs to $0. The same is true with Medicare or Medicare Advantage Plans. The amount that either plan pays toward your eligible medical bills applies to your CHM Personal Responsibility. The CHM staff will make any adjustments needed and will send you the correct amount of funds when your bills are shared.

Does CHM share bills for nursing home or travel expenses?

CHM’s goal is to help you prepare for unexpected events and to help you as best we can to be secure as you grow older.

According to the CHM Guidelines, bills for nursing homes are ineligible for sharing. Long-term care insurance is a great option for people who may need nursing home benefits. More information about costs is available by contacting your insurance agent.

Medical transportation and traveling expenses are defined separately in the CHM Guidelines. At the Gold level, CHM cannot share bills incurred for medical transportation from the site of your emergency to a medical facility.

However, bills for medical transportation are eligible for sharing at the Gold level when:

  • you’re in a life-threatening situation; and
  • you’re transported from one hospital to the nearest hospital than can provide the necessary services; and
  • the reason for the transfer is because the first hospital cannot adequately care for you.

(Medical transportation bills on the Silver and Bronze level are not eligible for sharing.)

Travel expenses are not eligible for sharing.

Will CHM help with my medical costs if I’m traveling and need emergency medical care?

Circumstances are similar regardless of your location. Bills will be shared if they meet CHM’s Guidelines.

What happens if I receive treatment from a doctor or hospital that doesn’t accept Medicare?

Though CHM doesn’t have a provider network, please note that if you choose to go to a non-participating Medicare provider, CHM can only share 20 percent of your eligible medical charges. For your benefit, please choose providers who accept Medicare.

Do Bring-a-Friend credits still apply if I have both Medicare and CHM?

A great advantage of being a CHM member is that you can receive a free month of membership for each new membership you bring into CHM. Members who participate in Medicare are included. Referring a friend will earn you one free month when your friend submits their third monthly financial gift.

When should I let CHM know I’m dropping because of Medicare?

Though we encourage you to keep CHM as a complement to Medicare, the decision is, of course, yours. You can discontinue your membership at any time. You must give a 30-day notice for the cancellation to take effect.

If you’d like to drop CHM but have bills that have not been shared, please call CHM for additional assistance.

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