Insurance and Christian Science

Coverage of Christian Science health care services

Various U.S. federal, state, and private health insurance plans provide for the reimbursement of Christian Science nursing care and practitioner treatment. The U.S. Federal Office has been working to increase the availability of insurance options that cover these types of care.

Medicare and Christian Science nursing facilities

Seventeen Christian Science nursing facilities across the United States are Medicare providers. (Find out more from the Commission for Accreditation of Christian Science Nursing Organizations/Facilities, Inc.)

Other insurance plans covering Christian Science care

By clicking on the links below, you can find a sampling of insurance plans we have on record that accommodate Christian Science care.

If you are aware of changes to any of these plans such that they no longer include Christian Science care services or know of other plans that do that we haven’t listed, please let us know.

Note that this is an informational resource only; you will want to check directly with your insurance provider to learn more about the specific plans and most current coverage information, and to determine whether or not they comply with the Affordable Care Act.

Does the health insurance plan offered by your employer not include Christian Science care services? Write to your employer to ask that Christian Science care services be included as a covered benefit!

High-deductible plans (also sometimes called “catastrophic” or “self-directed” plans) have become a popular option for obtaining emergency, safety net-type coverage for large, unforeseen health care expenses. Monthly premiums for these policies are lower than for other health plans, because the annual deductibles are higher. The potential downside to such plans is that if you incur a health expense in a particular plan year, you may have to pay more out-of-pocket until your deductibles are satisfied and the insurance kicks in.

Some high-deductible plans called “HSA-compatible health plans” can also be combined with health savings accounts (HSAs), which can be used to pay for qualified health care expenses not covered by your health plan, and might include care by Christian Science practitioners, Christian Science nurses, and Christian Science nursing facilities.*

When it comes to the ACA, some levels of high-deductible coverage will satisfy the law’s qualification standards, and some won’t. Many states offer coverage options to the public generally that are considered “catastrophic” and that meet the ACA’s requirements. Some of the options may only be available to those under the age of 30 or with low incomes and have more limited coverage. You can learn what plans are available to you on your state’s online insurance exchange.

*Please note that some high-deductible coverage is compatible for using in conjunction with a health savings account (HSA) and some is not. If you are interested in pairing high-deductible coverage with an HSA, you will want to verify that the coverage is an HSA-compatible health plan. It should reference "HSA" somewhere in the plan name or description, but it would also be good to verify that in writing with the insurance carrier.

What are HSAs?

Health savings accounts (HSAs) are custodial accounts that can be set up through financial institutions such as banks and credit unions, either directly by an individual or through an employer-sponsored plan. HSAs provide tax benefits to an individual for setting aside money to pay for current and future health care expenses. Tax laws only allow establishment of and contribution to an HSA when the account holder has health coverage through an HSA-compatible health plan (also sometimes referred to as a “high-deductible”, “self-directed”, or “catastrophic” health insurance plan).* Those kinds of plans usually have lower monthly premiums than other health plans do—because the annual deductibles are higher. The motivation behind the HSA-compatible plan is to encourage saving (or investing) of money that would otherwise be spent on health insurance premiums, to give the account holder more discretion in how those dollars are used to pay for immediate or future out-of pocket health care needs.

Who can set up an HSA?

Generally speaking, if you are covered by an HSA-compatible health plan, you can set up an HSA. Except for some limited exceptions, such as dental, vision, accident, disability and long term care plans, you are not eligible to establish an HSA if you have other health coverage through a non-HSA-compatible health plan, including Medicare. 

Contributions to an HSA

Contributions to the HSA can only be made when the account holder has health coverage through an HSA-compatible health plan. The IRS sets annual contribution limits, and contributions can come from a variety of sources, including account holders, employers, family members, and even from a limited one-time roll-over of IRA funds. These contributions are not taxed, nor are distributions (provided they are used for qualifying health care expenses). If HSA funds are used for non-qualifying expenses before age 65, the account holder not only is obligated to pay regular income tax on the distribution, but is also subject to a penalty for early withdrawal. Once the account holder turns 65, non-qualifying distributions are subject only to regular income tax, without penalty.

HSAs and Christian Science care

The determination of what health/medical expenses can be legally paid for by an HSA is governed by Section 213(d) of the Internal Revenue Code, which defines “medical expense” for purposes of income tax deduction to include amounts paid “for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body.”

Accordingly, over the years, payments made by individuals to Christian Science practitioners, Christian Science nurses, and Christian Science nursing facilities that relate to the healing of physical or mental conditions generally have been treated as tax-deductible under Section 213(d) of the Internal Revenue Code.  This is consistent with IRS regulations interpreting this section, which approve expenses for “treatments affecting any portion of the body” and for the “prevention or alleviation of a physical or mental defect or illness”, including “hospital” and “nursing services” and “other diagnostic and healing services”.  While this would not likely extend to expenses unrelated to a health condition, there appears to be great flexibility for coverage of expenses that directly relate to healing of a physical or mental condition.

However, you should not construe this as individual legal advice. Your eligibility to establish and contribute to an HSA, as well as the eligibility of specific health/medical expenses, should be discussed with an attorney, tax advisor, or benefits consultant that is qualified to advise you under your particular tax circumstances.

*Please note that some high-deductible coverage is compatible for using in conjunction with a health savings account (HSA) and some is not. If you are interested in pairing a high-deductible health plan with an HSA, you will want to verify that the coverage is an HSA-compatible health plan. It should reference "HSA" somewhere in the plan name or description, but you should also verify that in writing with the insurance carrier.

The following health plans under the FEHB Program provide some form of coverage for Christian Science services.  Because the services covered and extent of the coverage varies among the plans, you should review the plan materials carefully and direct any questions to the specific health plan.

Military and dependents plans

  • TRICARE
  • Alaska state employee plan
  • CalPERS Choice Basic plan
  • Illinois state employee plan
  • Illinois state retiree, annuitant, and survivor plan
  • Los Angeles City retired employee plan
  • Missouri state employee plan
  • Nevada state employee plan
  • Oklahoma state employee plan
  • Oregon state employee plan
  • Self-insured schools of California plan
  • South Dakota state employee plan
  • West Virginia retired public employee plan

Private plans

  • Darden Restaurants
  • General Electric
  • IBM
  • Intel
  • PacifiCorp
  • Providence Medicare Extra
  • Screen Actors Guild
  • Smucker's
  • State Farm (employees)
  • United Airlines

Individual plans

  • Serving Christian Scientists ("SCS")

The services covered and extent of coverage of Christian Science services provided in the private health plans below may vary, so you should review the plan materials carefully and direct any specific coverage questions to the plan involved.  If you are covered under an employer health plan, your Human Resources department may also be able to help you if you have questions.

  • Amherst College
  • Boston Architectural College
  • Boston Conservatory
  • Boston University
  • Brandeis University
  • Hampshire College
  • Lesley University
  • * Massachusetts Community College System
  • Montserrat College of Art
  • Mount Holyoke College
  • New England Institute of Art
  • Smith College
  • Tufts University
  • UMass Amherst
  • UMass Boston
  • UMass Lowell
  • Wellesley College

Massachusetts Community College System includes Berkshire CC, Bristol CC, Bunker Hill CC, Cape Cod CC, Greenfield CC, Holyoke CC, Massachusetts Bay CC, Massasoit CC, Middlesex CC, Mount Wachusett CC, Northern Essex CC, North Shore CC, Quincy College, Quinsigamond CC, Roxbury CC, and Springfield Technical CC.

Hey, college and grad students in Massachusetts!

You may know that every college and graduate student in Massachusetts is required to carry health insurance. But did you know that since June 2009, Massachusetts law has required all student health insurance plans to cover "services delivered in accordance with the healing practices of Christian Science"? Many Massachusetts colleges and universities are already complying with this requirement (see list above), but many others don't know this law exists. If your school's student health plan doesn't currently cover Christian Science care and you'd like to change that, we can help you—let us know!