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CMS administers Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and the Health Insurance Marketplace, providing health coverage to over 160 million Americans.
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the nation's major healthcare programs. CMS plays a vital role in ensuring that Americans have access to quality, affordable healthcare.
CMS oversees Medicare, which provides health insurance to over 65 million seniors and people with disabilities, and Medicaid, which provides coverage to over 90 million low-income individuals and families. Together, these programs cover more than one-third of all Americans.
Medicare is a federal health insurance program established in 1965. It primarily serves Americans aged 65 and older, as well as certain younger individuals with disabilities and people with End-Stage Renal Disease.
Covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care services. Most people don't pay a premium for Part A if they or their spouse paid Medicare taxes while working.
Covers physician services, outpatient care, medical supplies, and preventive services. Part B has a monthly premium that most enrollees pay, along with an annual deductible and coinsurance.
An alternative to Original Medicare offered by private insurance companies approved by Medicare. These plans include all Part A and Part B benefits and often include prescription drug coverage and additional benefits like dental, vision, and hearing.
Helps cover the cost of prescription drugs. Part D plans are offered by private insurance companies approved by Medicare. Each plan has a list of covered drugs (formulary) and may have different costs and coverage rules.
Medicaid is a joint federal and state program that provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities. Medicaid is the single largest source of health coverage in the United States.
Each state administers its own Medicaid program within federal guidelines, which means eligibility rules, covered services, and provider payments can vary by state. The Affordable Care Act gave states the option to expand Medicaid to cover nearly all adults with incomes up to 138% of the Federal Poverty Level.
CHIP provides low-cost health coverage to children in families that earn too much to qualify for Medicaid but cannot afford private insurance. In some states, CHIP also covers pregnant women. Each state offers CHIP coverage and works closely with its state Medicaid program.
CHIP covers routine check-ups, immunizations, doctor visits, prescriptions, dental and vision care, inpatient and outpatient hospital care, laboratory and X-ray services, and emergency services.
The Health Insurance Marketplace, established under the Affordable Care Act, is a platform where individuals and families can shop for, compare, and enroll in health insurance plans. The Marketplace offers qualified health plans that cover essential health benefits, pre-existing conditions, and preventive care.
Financial assistance in the form of premium tax credits and cost-sharing reductions is available to help lower costs for eligible individuals and families. Open Enrollment typically runs from November 1 to January 15 each year.
Medicare is a federal health insurance program for people aged 65 and older, certain younger people with disabilities, and people with End-Stage Renal Disease. It covers hospital stays, medical services, prescription drugs, and more.
Medicare is a federal program providing health coverage based on age or disability, regardless of income. Medicaid is a joint federal and state program that provides health coverage based on income and financial need.
Medicare has four parts: Part A (Hospital Insurance) covers inpatient hospital stays, skilled nursing, hospice, and home health care. Part B (Medical Insurance) covers doctor visits, outpatient care, and preventive services. Part C (Medicare Advantage) is an alternative to Original Medicare offered by private companies. Part D covers prescription drug costs.
You can enroll during your Initial Enrollment Period (3 months before your 65th birthday, your birthday month, and 3 months after). You can also enroll during the General Enrollment Period (January 1 - March 31 each year) or Special Enrollment Periods if you qualify.
The Medicare Open Enrollment Period runs from October 15 to December 7 each year. During this time, you can change your Medicare health plan and prescription drug coverage for the following year.
Yes, Medicare covers many preventive services at no cost, including annual wellness visits, flu shots, hepatitis B shots, pneumococcal shots, cardiovascular disease screenings, diabetes screenings, and various cancer screenings.