Medicare Reimbursement
Medicare is the nation’s health insurance program for people over 65 years of age and certain people with disabilities. It is administered by the Centers for Medicare and Medicaid Services (CMS) of the U.S. Dept. of Health and Human Services.
The Medicare program is divided into the following sections:
Medicare Part A (hospital insurance) helps pay for inpatient hospital care, inpatient care in a skilled nursing facility, home health care and hospice care. Part A has deductibles and co-insurance. However most people don’t have to pay premiums for Medicare Part A.
Medicare Part B (medical insurance) helps pay for doctor’s services, outpatient hospital services, durable medical equipment and a number of other medical supplies and services not covered by Medicare Part A. Medicare Part B has premiums, deductibles and co-insurance amounts that you must pay yourself or through coverage by another insurance plan.
Medicare Part C (Medicare Advantage) is a part of Medicare that allows private health insurance companies to provide Medicare benefits. This is usually offered by private health plans such as HMOs and PPOs.
Medicare Part D (prescription drug insurance) helps pay for prescription drugs. Medicare Part D is provided by private insurance companies that have contracts with the federal government. Part D is not provided directly by the federal government like Medicare Part A and B.
Please contact WHCA/WiCAL Vice President of Reimbursement Policy Kate Dickson for more information.