Medicare (United States)

MedicareMedicare (US)Medicare Catastrophic Coverage ActMedicare Part BNational Bipartisan Commission on the Future of MedicareUS MedicareMedicare card holdersMedicare in the United StatesMedicare,Centers for Medicare & Medicaid Services
Medicare is a national health insurance program in the United States, begun in 1966 under the Social Security Administration (SSA) and now administered by the Centers for Medicare and Medicaid Services (CMS).wikipedia
1,280 Related Articles

Lyndon B. Johnson

Lyndon JohnsonJohnsonLyndon Baines Johnson
In July 1965, under the leadership of President Lyndon Johnson, Congress enacted Medicare under Title XVIII of the Social Security Act to provide health insurance to people age 65 and older, regardless of income or medical history.
In domestic policy, Johnson designed the "Great Society" legislation to expand civil rights, public broadcasting, Medicare, Medicaid, aid to education, the arts, urban and rural development, public services and his "War on Poverty".

Social Security Amendments of 1965

Social Security Act of 1965Medicare Actit was paid
In July 1965, under the leadership of President Lyndon Johnson, Congress enacted Medicare under Title XVIII of the Social Security Act to provide health insurance to people age 65 and older, regardless of income or medical history.
The Social Security Amendments of 1965, was legislation in the United States whose most important provisions resulted in creation of two programs: Medicare and Medicaid.

Hospice

hospice carehospicesterminal care
The government added hospice benefits to aid elderly people on a temporary basis in 1982, and made this permanent in 1984.
In the United States, the term is largely defined by the practices of the Medicare system and other health insurance providers, which cover inpatient or at home hospice care to terminal patients who are medically certified to have less than six months to live.

Medicaid

Medicaid fraudMedicaid expansionMedical Assistance
The Centers for Medicare and Medicaid Services (CMS), a component of the U.S. Department of Health and Human Services (HHS), administers Medicare, Medicaid, the Children's Health Insurance Program (CHIP), the Clinical Laboratory Improvement Amendments (CLIA), and parts of the Affordable Care Act (ACA) ("Obamacare").
Medicaid also offers benefits not normally covered by Medicare, including nursing home care and personal care services.

End Stage Renal Disease Program

end stage renal diseaseend-stage ESRD patientsend-stage renal disease program
It primarily provides health insurance for Americans aged 65 and older, but also for some younger people with disability status as determined by the Social Security Administration, as well as people with end stage renal disease and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease).
In 1972 the United States Congress passed legislation authorizing the End Stage Renal Disease Program (ESRD) under Medicare.

George W. Bush

BushPresident BushPresident George W. Bush
In 2003, under President George W. Bush, a Medicare program for covering almost all self-administered prescription drugs was passed (and went into effect in 2006) as Medicare Part D.
He signed into law broad tax cuts, the Patriot Act, the No Child Left Behind Act, the Partial-Birth Abortion Ban Act, Medicare prescription drug benefits for seniors, and funding for the AIDS relief program known as PEPFAR.

Specialty Society Relative Value Scale Update Committee

Walt LarimoreMedicare fee scheduleRelative Value Scale Update Committee
The Specialty Society Relative Value Scale Update Committee (or Relative Value Update Committee; RUC), composed of physicians associated with the American Medical Association, advises the government about pay standards for Medicare patient procedures performed by doctors and other professionals under Medicare Part B. A similar but different CMS process determines the rates paid for acute care and other hospitals—including skilled nursing facilities—under Medicare Part A. The rates paid for both Part A and Part B type services under Part C are whatever is agreed upon between the sponsor and the provider.
The Specialty Society Relative Value Scale Update Committee or Relative Value Update Committee (RUC, pronounced "ruck") is a volunteer group of 31 physicians who have made highly influential recommendations on how to value a physician's work when computing health care prices in the United States' public health insurance program Medicare.

Health care prices in the United States

health care costshealth care priceshealthcare costs
In addition, the fact that the number of workers per enrollee will decline from 3.7 to 2.4 and that overall health care costs in the nation are rising pose substantial financial challenges to the program.
During 2016, the U.S. population overall was approximately 325 million, with 53 million persons 65 years of age and over covered by the federal Medicare program.

Medicare Access and CHIP Reauthorization Act of 2015

MACRAMedical Access and CHIP Reauthorization Act (MACRA)Medicare Access and CHIP Reauthorization Act
In response to these financial challenges, Congress made substantial cuts to future payouts to providers (primarily acute care hospitals and skilled nursing facilities) as part of PPACA in 2010 and the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and policymakers have offered many additional competing proposals to reduce Medicare costs further.
It changes the payment system for doctors who treat Medicare patients.

Medicare dual eligible

dual eligiblesdual-eligibledually eligible
Some beneficiaries are dual-eligible.
Dual-eligible beneficiaries (Medicare dual eligibles or "duals") refers to those qualifying for both Medicare and Medicaid benefits.

Medicare Part D

Part DMedicare Prescription DrugPrescription Drug Plan
Medicare Part D covers many prescription drugs, though some are covered by Part B. In general, the distinction is based on whether or not the drugs are self-administered but even this distinction is not total.
Medicare Part D, also called the Medicare prescription drug benefit, is an optional United States federal-government program to help Medicare beneficiaries pay for self-administered prescription drugs through prescription drug insurance premiums (the cost of almost all professionally administered prescriptions is covered under optional Part B of United States Medicare).

Social Security (United States)

Social SecuritySocial Security ActSocial Security System
Increased spending for Social Security will occur at the same time as increases in Medicare, as a result of the aging of the baby boomers.

Health insurance

medical insurancehealthhealth benefits
Medicare is a national health insurance program in the United States, begun in 1966 under the Social Security Administration (SSA) and now administered by the Centers for Medicare and Medicaid Services (CMS).
The primary public programs are Medicare, a federal social insurance program for seniors and certain disabled individuals; and Medicaid, funded jointly by the federal government and states but administered at the state level, which covers certain very low income children and their families.

United States Department of Health and Human Services

Department of Health and Human ServicesU.S. Department of Health and Human ServicesHealth and Human Services
The Centers for Medicare and Medicaid Services (CMS), a component of the U.S. Department of Health and Human Services (HHS), administers Medicare, Medicaid, the Children's Health Insurance Program (CHIP), the Clinical Laboratory Improvement Amendments (CLIA), and parts of the Affordable Care Act (ACA) ("Obamacare").
However, OIG Special Agents have special skills in investigating white collar crime related to Medicare and Medicaid fraud and abuse.

Medigap

Medicare supplementMedicare supplement insuranceMedicare Supplemental Coverage
Part B coverage begins once a patient meets his or her deductible ($183 for 2017), then typically Medicare covers 80% of the RUC-set rate for approved services, while the remaining 20% is the responsibility of the patient, either directly or indirectly by private group retiree or Medigap insurance.
Medigap (also called Medicare supplement insurance or Medicare supplemental insurance) refers to various private health insurance plans sold to supplement Medicare in the United States.

Medical necessity

medically necessarymedical reasonmedically unnecessary
All Medicare benefits are subject to medical necessity.
Medicare pays for medical items and services that are "reasonable and necessary" for a variety of purposes.

Social Security number

Social Security cardsocial security numbersSSN
Previous cards had ID numbers containing beneficiaries' Social Security numbers; the new ID numbers are randomly generated and not tied to any other personally identifying information.
Social Security was originally a universal tax, but when Medicare was passed in 1965, objecting religious groups in existence prior to 1951 were allowed to opt out of the system.

Nursing home care

nursing homenursing homescare home
Part A fully covers brief stays for rehabilitation or convalescence in a skilled nursing facility and up to 100 days per medical necessity with a co-pay if certain criteria are met:
Medicare and Medicaid began to make up much of the money that would filter through the homes and the 1965 amendment laws enforced nursing homes to comply with safety codes and required registered nurses to be on hand at all times.

Medicare Prescription Drug, Improvement, and Modernization Act

Medicare Modernization ActMedicare Modernization Act of 2003Medicare Act of 2003
In 2003, under President George W. Bush, a Medicare program for covering almost all self-administered prescription drugs was passed (and went into effect in 2006) as Medicare Part D.
It produced the largest overhaul of Medicare in the public health program's 38-year history.

Durable medical equipment

durable" medical equipment
Part B also helps with durable medical equipment (DME), including but not limited to canes, walkers, lift chairs, wheelchairs, and mobility scooters for those with mobility impairments.
In some cases certain Medicare benefits, that is, whether Medicare may pay for the item.

Railroad Retirement Board

Railroad Retirement ActRailroad RetirementRailroad Unemployment Insurance Act
In connection with the retirement program, the RRB has administrative responsibilities under the Social Security Act for certain benefit payments and railroad workers' Medicare coverage.

American Medical Association

AMAAmerican Medical Association (AMA) American Medical Association
The Specialty Society Relative Value Scale Update Committee (or Relative Value Update Committee; RUC), composed of physicians associated with the American Medical Association, advises the government about pay standards for Medicare patient procedures performed by doctors and other professionals under Medicare Part B. A similar but different CMS process determines the rates paid for acute care and other hospitals—including skilled nursing facilities—under Medicare Part A. The rates paid for both Part A and Part B type services under Part C are whatever is agreed upon between the sponsor and the provider.
The American Medical Association's vehement campaign against Medicare in the 1950s and 1960s included Operation Coffee Cup, supported by Ronald Reagan.

Bess Truman

BessBess WallaceMrs. Truman
Former President Harry S. Truman and his wife, former First Lady Bess Truman became the first recipients of the program.
When President Lyndon Johnson signed Medicare into law in 1965, the Trumans were the first senior citizens to receive Medicare cards, presented to them by Johnson at the White House.

Health information technology

Health IThealthcare information technologyHealthcare IT
Cost reduction may also be effected by reducing medical errors, investment in healthcare information technology, improving transparency of cost and quality data, increasing administrative efficiency, and by developing both clinical/non-clinical guidelines and quality standards.
The other $17 billion in incentives comes from Medicare and Medicaid funding for those who adopt HIT before 2015.