Medicare and Medicaid


MEDICARE

As a federally-certified Religious Non-medical Health Care Institution (RNHCI), Glenmont is eligible for participation in the Medicare program.

Almost all residents of the U.S. and its territories who are 65 or older are eligible for Medicare benefits.  Details about the Medicare program are explained in Your Medicare Handbook, a pamphlet available from Social Security offices. The Social Security laws may be changed at any time. Please contact Glenmont for current information about admission and coverage.

Eligibility for Medicare-covered care at a nursing facility for Christian Scientists

There are several conditions to be met before you can receive Medicare-covered care.
You must first have a Social Security health insurance claim card (obtained through local Social Security offices). You must then be admitted to an accredited/certified Christian Science Nursing facility which is participating in the Medicare program (not all do so). Finally, the Christian Science Nursing facility’s Utilization Review Committee (URC) must determine that your needs require covered care.

Not all Christian Science nursing care in a Christian Science Nursing facility is Medicare-covered.  This is a surprise to many Christian Scientists expecting Medicare coverage.

Only Christian Science nursing care that requires the skills, judgment, observation or direct care of Christian Science Journal-listed nurses is covered by Medicare.  Other Christian Science nursing care is not eligible for Medicare coverage.

The URC will periodically review your Christian Science Nursing needs to determine whether or not you continue to be eligible for covered care.

Program Specifics

Medicare coverage in a Christian Science nursing facility is covered under Part A. No other part of Medicare, including Part B, can be used to pay for services at a Christian Science nursing facility.

Part A:  This will cover certain costs of staying at an accredited/certified nursing facility for Christian Scientists:
Christian Science Nursing care where the services of a Christian Science nurse are required
Standard room and board
Christian Science Nursing supplies and equipment

The following are not covered:

  • Care that can be rendered primarily by individuals such as nurses aides, student nurses, and nursing assistants
  • Rest and study
  • Personal convenience extras (e.g., hair styling)
  • Private duty Christian Science Nursing (where a nurse is hired by an individual who has been admitted to a facility)
  • Christian Science practitioners’ fees

(Note: Your Medicare coverage may be adjusted when you have other coverage such as Workers’ Compensation, auto liability, or employer group policy coverage.)

How long and how much does Medicare pay?

In order to be eligible for Medicare in a Christian Science Nursing facility, the patient must first sign an “election” form, notifying the government of his or her decision to receive Medicare coverage in a Christian Science setting. The patient may receive up to 90 days of “covered” care.  If the patient needs “covered” care for a longer period, he or she may draw upon lifetime “reserve days.” The patient will pay a deductible for the first 60 days of coverage ($1,364.00 in 2019). For days 61-90, the patient must pay a daily coinsurance premium ($341.00 per day in 2019).  Beginning on day 91, if the patient chooses to draw on the lifetime “reserve days,” he must pay a higher daily coinsurance premium ($682.00 Per day in 2019). Before a new Medicare benefit period can begin, 60 days must elapse where no “covered” care is needed.

 

MEDICAID

Glenmont is no longer accepting patients that are enrolled in the Medicaid program from the State of Ohio; we are instead referring patients to the National Fund for Christian Science Nursing or NFCSN.

The Health Insurance Portability and Accountability Act (HIPAA) was passed in 1996.
This Act protects the personal, health and financial information of patients.
We are required to keep this information private by utilizing precautions and policies
that prohibit the release or transmission of patient information to unauthorized sources.