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Health Care Terminology: Medicare & Medicaid

Center for Medicare and Medicaid Services (CMS)

The Centers for Medicare & Medicaid Services (CMS) is a federal agency, part of the Department of Health and Human Services, that runs the Medicare, Medicaid, and Children's Health Insurance Programs.

www.cms.gov

Medicaid

Medicaid is a joint federal and state insurance program that provides free or low-cost health coverage to some low-income people, families and children, pregnant women, the elderly, and people with disabilities.  Medicaid is the single largest source of health coverage in the US.  Medicaid benefits and coverage vary between states and each state has its own eligibility standards.

www.medicaid.gov

Medicare

Medicare is a federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease.  Medicare is financed through the Social Security system in which employers and employees each pay 1.45% of wages and salaries to Medicare.

www.medicare.gov

Medicare Part A

Medicare Part A (Hospital Insurance) covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part B

Medicare Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.  People who are eligible for Medicare Part A can elect to pay for Medicare Part B with a monthly premium.

Medicare Part C

Medicare Part C (Medicare Advantage Program) is a type of Medicare health plan offered by private companies that contract with Medicare to provide patients with all of their Part A and Part B benefits, with Medicare subsidizing the premium for the private plan instead of paying providers and hospitals directly. 

Medicare Advantage Programs include Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans.

Medicare Part D

Medicare Part D (prescription drug coverage) provides partial prescription drug coverage to original Medicare, some Medicare cost plans, some Medicare private fee-for-service plans, and Medical Medical Savings Account Plans.  These plans are offered by insurance companies and other private companies approved by Medicare.


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