Center for Medicare and Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the U.S. Department of Health and Human Services that administers the Medicare and Medicaid programs. The agency's mission is to improve access to high-quality healthcare services for people in the United States, particularly those who are elderly, disabled, or low-income.

CMS is responsible for a range of activities related to the administration of Medicare and Medicaid, including:

1. Overseeing the Medicare and Medicaid programs: CMS is responsible for developing policies and regulations related to Medicare and Medicaid and overseeing the administration of these programs by states, health plans, and healthcare providers.

2. Managing payment and reimbursement: CMS establishes payment rates and reimbursement policies for healthcare providers, including hospitals, physicians, and other healthcare professionals.

3. Developing quality standards: CMS develops and enforces quality standards for healthcare providers who participate in Medicare and Medicaid, with the goal of ensuring that patients receive high-quality care.

4. Educating beneficiaries: CMS provides education and outreach to Medicare and Medicaid beneficiaries, helping them understand their coverage options and make informed decisions about their healthcare.

5. Conducting research and analysis: CMS conducts research and analysis on healthcare utilization, costs, and outcomes, with the goal of improving the effectiveness and efficiency of the Medicare and Medicaid programs.

Overall, CMS plays a critical role in the administration and oversight of the Medicare and Medicaid programs, working to ensure that beneficiaries have access to high-quality, affordable healthcare services.

www.medicare.gov 

T 1 800 MEDICARE

What is the difference between Medicare and Medicaid? 

Medicare and Medicaid are both government-run health insurance programs in the United States, but they are designed to serve different populations and cover different types of services.

Medicare is a federal health insurance program that primarily serves people who are 65 years of age or older, as well as people with certain disabilities and individuals with end-stage renal disease. Medicare covers a range of healthcare services, including hospital stays, doctor visits, prescription drugs, and some preventive care.

Medicaid, on the other hand, is a joint federal-state program that provides health insurance coverage to people with limited income and resources. The program is primarily designed to serve low-income families, pregnant women, children, and people with disabilities. Medicaid covers a range of healthcare services, including hospital stays, doctor visits, prescription drugs, and long-term care.

One of the key differences between Medicare and Medicaid is how they are funded. Medicare is funded through payroll taxes, premiums, and general revenue, while Medicaid is funded through a combination of federal and state funds.

Another difference is how eligibility is determined. Medicare eligibility is primarily based on age and disability status, while Medicaid eligibility is primarily based on income and household size.

In summary, while both Medicare and Medicaid are government-run health insurance programs, they serve different populations and cover different types of services.