Centers for Medicare and Medicaid Services (CMS)

From WikiMD's Wellness Encyclopedia

The Centers for Medicare & Medicaid Services (CMS), commonly abbreviated to CMS, is a federal agency within the United States Department of Health and Human Services (HHS) that administers the nation's major healthcare programs Medicare and Medicaid. CMS oversees the insurance coverage for over 100 million individuals through these programs, which support the health care of many Americans, including those with specific conditions and financial situations.

CMS logo

Medicare Program[edit | edit source]

Medicare is a national health insurance program providing coverage to three groups of individuals:

  • People age 65 or older
  • People under age 65 with certain disabilities
  • People of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant)

Medicare Coverage Parts[edit | edit source]

Medicare is divided into parts, each designed to cover specific services:

  • Medicare Part A (Hospital Insurance) - This part provides coverage for inpatient hospital stays, care in skilled nursing facilities, hospice care, and some home health care services. The majority of enrollees do not pay a premium for Part A due to having paid payroll taxes during employment.
  • Medicare Part B (Medical Insurance) - Part B covers outpatient medical services, including doctors' visits, outpatient care, preventive services, and supplies that are necessary for treating a health condition. This part requires the payment of a monthly premium.
  • Medicare Part D (Prescription Drug Coverage) - This part offers prescription drug coverage to everyone with Medicare. Enrollment in a Medicare-approved plan is required, and most enrollees pay a monthly premium for this coverage.

Glossary of CMS Terms[edit | edit source]

Below is a glossary of terms associated with CMS and its administered programs:

  • Centers for Medicare & Medicaid Services (CMS) - The federal agency responsible for administering Medicare and assisting with Medicaid.
  • Medicare - A federal health insurance program for people 65 and over, certain younger people with disabilities, and people with End-Stage Renal Disease.
  • Medicaid - A joint federal and state program that helps with medical costs for some people with limited income and resources.
  • Medicare Part A - The part of Medicare that covers inpatient hospital stays, skilled nursing facility care, and some home health care.
  • Medicare Part B - The portion of Medicare that covers doctors' services, outpatient care, medical supplies, and preventive services.
  • Medicare Part D - Medicare's prescription drug coverage that requires enrollment in a Medicare-approved plan.
  • Premium - A periodic payment to Medicare, an insurance company, or a health care plan for health or prescription drug coverage.
  • United States Department of Health and Human Services (HHS) - The federal department overseeing health and public welfare.

Centers for Medicare and Medicaid Services (CMS) Resources

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Contributors: Prab R. Tumpati, MD