Many people may find it confusing to navigate Medicare offerings. The Centers for Medicare & Medicaid Services (CMS) aims to provide health coverage to people in the United States and help them through the process.
This article and accompanying infographic outline the services the CMS offers and important enrollment dates to know.
The CMS is a federal agency that provides healthcare coverage to more than 100 million people across the nation through Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the Health Insurance Marketplace. It is part of the Department of Health and Human Services.
Medicare is federal healthcare insurance for people aged 65 and older in the United States. Younger people with certain conditions may also be eligible to enroll.
Original Medicare includes:
- Part A: This is hospital insurance, which includes coverage of hospital stays, as well as physical, occupational, and speech therapy.
- Part B: This provides medical coverage, such as medically necessary doctor’s visits, outpatient hospital visits, home healthcare costs, and preventive care services.
Eligible people may also enroll in the following as an alternative to original Medicare:
- Part C: This replaces original Medicare (Part A and Part B). It is known as Medicare Advantage or Medicare+ Choice. It covers services in parts A and B plus additional services, such as dental, vision, or hearing services. Most plans also include prescription drug coverage (Part D).
- Part D: This is insurance for prescription drug costs.
Both Part C and Part D are offered by private insurance companies approved by the CMS.
Medicaid is a social welfare or social protection program for low income households with few resources. Individuals must meet certain criteria to qualify for the program. Criteria are determined by each state, so eligibility and services vary from state to state.
CHIP provides low cost health coverage to children and teens. People can apply for CHIP at any time, and coverage can begin immediately, any time of the year.
CHIP benefits differ in each state but may include coverage for:
- routine check-ups
- doctor’s appointments
- dental and vision care
- inpatient and outpatient hospital care
- laboratory and X-ray services
- emergency services
The Health Insurance Marketplace
The CMS also oversees the Health Insurance Marketplace. The Health Insurance Marketplace can help people:
- Compare health insurance plans for coverage and affordability.
- Get answers to questions about healthcare insurance.
- Find out if they are eligible for tax credits for private insurance or health programs like Medicaid or CHIP.
- Enroll in a health insurance plan that meets their needs.
The CMS provides vital healthcare coverage to millions of people in the United States. When people are ready, they can find out which plan best suits their needs and budget by visiting the Health Insurance Marketplace.