http://www.fpnotebook.com/

MedicareAka: Medicare Part A, Medicare Part B, Medicare Part C, Medicare Part D

Types: Medicare Part A
1. Funded by social security, taxes, hospital insurance
2. Covers hospital care, home care and Hospice
3. Reimbursement via medicare intermediaries
  1. Payments based on per episode per diagnosis
Types: Medicare Part B
1. Funding
  1. Participants pay 25% of costs (~$50 per month)
  2. General taxes pay 75% of costs
  3. Medicare Supplemental Trust Fund
2. Covers
  1. Clinician visits, PT and OT, Mental Health
  2. Lab, XRay, Durable medical equipment
3. Reimbursement
  1. Deductible: $100
  2. Co-Payment: 20%
Types: Medicare Part C
1. Medicare Choice Plan
2. Benificiary may choose private pay, medical savings accounts, or managed care
Types: Medicare Part D
1. Prescription Drug benefit
Resources
1. EDispense Vaccine Manager for Medicare Part D Vaccine Reimbursement
  1. https://enroll.edispense.com/ws_enroll/
References
1. Dial (2003) AAFP Board Review Lecture, Seattle

Medicare (C0018717)
Definition (MSH)	Federal program, created by Public Law 89-97, Title XVIII-Health Insurance for the Aged, a 1965 amendment to the Social Security Act, that provides health insurance benefits to persons over the age of 65 and others eligible for Social Security benefits. It consists of two separate but coordinated programs: hospital insurance (MEDICARE PART A) and supplementary medical insurance (MEDICARE PART B). (Hospital Administration Terminology, AHA, 2d ed and A Discursive Dictionary of Health Care, US House of Representatives, 1976)
Definition (NCI)	A program under the U.S. Social Security Administration that reimburses hospitals and physicians for medical care provided to qualifying people over 65 years old.
Concepts	Regulation or Law (T089)
English	HEALTH INSURANCE AGED DISABLED, HEALTH INSURANCE AGED DISABLED TITLE 18, HEALTH INSURANCE AGED TITLE 18, Medicare
Credits	Derived from the NIH UMLS (Unified Medical Language System)

Medicare Part A (C0079817)
Definition (MSH)	The compulsory portion of Medicare that is known as the Hospital Insurance Program. All persons 65 years and older who are entitled to benefits under the Old Age, Survivors, Disability and Health Insurance Program or railroad retirement, persons under the age of 65 who have been eligible for disability for more than two years, and insured workers (and their dependents) requiring renal dialysis or kidney transplantation are automatically enrolled in Medicare Part A.
Concepts	Regulation or Law (T089)
English	HOSP INSURANCE PROGRAM MEDICARE, MEDICARE A, MEDICARE HOSP INSURANCE PROGRAM, Medicare Hospital Insurance Program, Medicare Part A
Credits	Derived from the NIH UMLS (Unified Medical Language System)

Medicare Part B (C0079818)
Definition (MSH)	The voluntary portion of Medicare, known as the Supplementary Medical Insurance (SMI) Program, that includes physician's services, home health care, medical services, outpatient hospital services, and laboratory, pathology, and radiology services. All persons entitled to Medicare Part A may enroll in Medicare Part B on a monthly premium basis.
Concepts	Regulation or Law (T089)
English	MEDICARE B, Medicare Part B, MEDICARE SUPPLEMENTARY MED INSURANCE PROGRAM, Medicare Supplementary Medical Insurance Program, SMI Program, SMI Programs, SUPPLEMENTARY MED INSURANCE PROGRAM MEDICARE
Credits	Derived from the NIH UMLS (Unified Medical Language System)

Medicare Part C (C0600580)
Definition (MSH)	The Balanced Budget Act (BBA) of 1997 establishes a Medicare+Choice program under part C of Title XVIII, Section 4001, of the Social Security Act. Under this program, an eligible individual may elect to receive Medicare benefits through enrollment in a Medicare+Choice plan. Beneficiaries may choose to use private pay options, establish medical savings accounts, use managed care plans, or join provider-sponsored plans.
Concepts	Regulation or Law (T089)
English	MEDICARE C, Medicare Choice, Medicare Part C, Medicare Plus Choice
Credits	Derived from the NIH UMLS (Unified Medical Language System)

Medicare Part D (C1955953)
Definition (MSH)	A stand-alone drug plan offered by insurers and other private companies to beneficiaries that receive their Medicare Part A and/or B benefits through the Original Medicare Plan. It includes Medicare Private Fee-for-Service Plans that do not offer prescription drug coverage and Medicare Cost Plans offering Medicare prescription drug coverage. The plan was enacted as the Medicare Prescription Drug, Improvement and Modernization Act of 2003 with coverage beginning January 1, 2006.
Concepts	Regulation or Law (T089)
English	Medicare Part D
Credits	Derived from the NIH UMLS (Unified Medical Language System)