Medicare Benefits and Financing

Background

MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). coverage has four parts. Part A covers inpatient hospital care (including inpatient drugs), some home health services, limited skilled-nursing home careA range of services provided in the home, including health-related care, personal care, and supportive services. , and hospice care. Part A requires no premiums. Part B, known as Traditional or Original MedicareOriginal Medicare,also known as Traditional or Fee-For-Service Medicare, works on a fee-for-service basis. This means that you can go to any doctor or hospital that accepts Medicare, anywhere in the United States, and Medicare will pay its share of the bill for any Medicare-covered service it… , covers physician services, some home health services, and outpatient services. It does require a monthly premium. Assistance is available for beneficiaries with low incomes. An alternative to traditional coverage is Part C, better known as the Medicare AdvantageMedicare Advantage (MA) health plans are offered by private Medicare approved companies as an alternative to Original Medicare. Medicare pays these companies a fixed amount per enrollee per month to provide benefits for Parts A, B, and (usually) D. ( MAMedicare Advantage (MA) health plans are offered by private Medicare approved companies as an alternative to Original Medicare. Medicare pays these companies a fixed amount per enrollee per month to provide benefits for Parts A, B, and (usually) D. ) program. It covers private health plans that contract with MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). . MAMedicare Advantage (MA) health plans are offered by private Medicare approved companies as an alternative to Original Medicare. Medicare pays these companies a fixed amount per enrollee per month to provide benefits for Parts A, B, and (usually) D. accounts for just over one-third of MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). enrollees, and that share is growing. Part D covers outpatient prescription drugs and can be purchased through a stand-alone plan or as part of an MAMedicare Advantage (MA) health plans are offered by private Medicare approved companies as an alternative to Original Medicare. Medicare pays these companies a fixed amount per enrollee per month to provide benefits for Parts A, B, and (usually) D. plan.

In 2017, about 34 percent of MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). beneficiaries enrolled in MAMedicare Advantage (MA) health plans are offered by private Medicare approved companies as an alternative to Original Medicare. Medicare pays these companies a fixed amount per enrollee per month to provide benefits for Parts A, B, and (usually) D. plans (see Medicare Advantage). MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). beneficiaries may also enroll in Part D for outpatient prescription drug coverage. This coverage is available through a “stand-alone” drug plan or MAMedicare Advantage (MA) health plans are offered by private Medicare approved companies as an alternative to Original Medicare. Medicare pays these companies a fixed amount per enrollee per month to provide benefits for Parts A, B, and (usually) D. plan.

Benefits: Beneficiaries in Traditional MedicareTraditional Medicare, also known as Original or Fee-For-Service Medicare, works on a fee-for-service basis. This means that you can go to any doctor or hospital that accepts Medicare, anywhere in the United States, and Medicare will pay its share of the bill for any Medicare-covered service it… may obtain covered services from any provider who accepts MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). patients, which most physicians across the country do. Because Traditional MedicareTraditional Medicare, also known as Original or Fee-For-Service Medicare, works on a fee-for-service basis. This means that you can go to any doctor or hospital that accepts Medicare, anywhere in the United States, and Medicare will pay its share of the bill for any Medicare-covered service it… pays for about 80 percent of the cost of a covered service, many MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). beneficiaries purchase private Medicare Supplement InsuranceGovernment-regulated private insurance—also called Medigap insurance—that can be purchased by Medicare beneficiaries to pay their deductible and cost sharing obligations, which can be substantial if they a serious health condition. to help pay cost-sharingThe share of insurance-covered costs that a person pays out of pocket, including deductibles, coinsurance, and copayments. It does not include premiums, balance billing amounts for non-network providers, or the cost of non-covered services. expenses. This supplement insurance is known as Medigap. Some MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). beneficiaries with low incomes receive assistance with cost-sharingThe share of insurance-covered costs that a person pays out of pocket, including deductibles, coinsurance, and copayments. It does not include premiums, balance billing amounts for non-network providers, or the cost of non-covered services. through a MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). Savings Program or a state MedicaidA joint federal/state program that provides health care and LTSS. However, to qualify for Medicaid LTSS, people must have extremely low assets and income, or they have to “spend down” most of their assets. program.

Individuals enrolled in MAMedicare Advantage (MA) health plans are offered by private Medicare approved companies as an alternative to Original Medicare. Medicare pays these companies a fixed amount per enrollee per month to provide benefits for Parts A, B, and (usually) D. plans typically receive all their care through their plan, choosing physicians and facilities from the plan's network. Those who obtain services from providers in the network usually have lower (or no) cost-sharingThe share of insurance-covered costs that a person pays out of pocket, including deductibles, coinsurance, and copayments. It does not include premiums, balance billing amounts for non-network providers, or the cost of non-covered services. . Unlike Traditional MedicareTraditional Medicare, also known as Original or Fee-For-Service Medicare, works on a fee-for-service basis. This means that you can go to any doctor or hospital that accepts Medicare, anywhere in the United States, and Medicare will pay its share of the bill for any Medicare-covered service it… , MAMedicare Advantage (MA) health plans are offered by private Medicare approved companies as an alternative to Original Medicare. Medicare pays these companies a fixed amount per enrollee per month to provide benefits for Parts A, B, and (usually) D. plans have an out-of-pocket spending cap. Some MAMedicare Advantage (MA) health plans are offered by private Medicare approved companies as an alternative to Original Medicare. Medicare pays these companies a fixed amount per enrollee per month to provide benefits for Parts A, B, and (usually) D. plans charge an additional plan-specific premium to enrollees.

Financing: Medicare Part AThis program covers inpatient hospital care, short stays in a skilled-nursing facility, home health care under certain conditions, and hospice care. Those who qualify for Medicare pay no premium for Part A. is mainly financed by payroll taxes. Employers and employees each pay 1.45 percent of wages to the Part A trust fund. Since 2013, high-wage workers pay an additional MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). tax of 0.9 percent on wages in excess of specified thresholds. The thresholds are $200,000 for single tax filers, $250,000 for married couples filing jointly, and $125,000 for married individuals filing separately.

Most Americans who are eligible for Social Security are entitled to Part A at no cost when they turn 65. But participation in Part B is voluntary and requires payment of a monthly premium. About 92 percent of those who participate in Part A also enroll in Part B. Part B is financed by both beneficiary premiums—which cover about 25 percent of costs—and federal general revenueRevenue that can be used for any purpose. , which covers the other 75 percent. MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). beneficiaries with low incomes and limited savings, who are enrolled in a MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). Savings Program or MedicaidA joint federal/state program that provides health care and LTSS. However, to qualify for Medicaid LTSS, people must have extremely low assets and income, or they have to “spend down” most of their assets. , do not pay Part B premiums. For these MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). beneficiaries with low incomes, MedicaidA joint federal/state program that provides health care and LTSS. However, to qualify for Medicaid LTSS, people must have extremely low assets and income, or they have to “spend down” most of their assets. pays their premiums and, for some, their cost-sharingThe share of insurance-covered costs that a person pays out of pocket, including deductibles, coinsurance, and copayments. It does not include premiums, balance billing amounts for non-network providers, or the cost of non-covered services. expenses. Individuals with incomes of more than $85,000 and couples with incomes of more than $170,000 have paid higher Part B premiums since 2007. And beginning in 2011, they paid higher Part D (prescription drugs) premiums as well.

Fiscal pressures: MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). faces long-term financial challenges that must be addressed. The 2018 MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). trustees’ report estimates that the Hospital Insurance Trust Fund, which funds Part A and is mainly financed by payroll taxes, will be solvent until 2026. In that year, current projections indicate that the trust fund will be able to cover 91 percent of Part A benefits unless policymakers can agree on some combination of raising additional revenue and maximizing the value of every dollar spent.

Continued increases in medical costs, rapid changes in medical technology, and the aging of the boomer generation—which will add 21 million enrollees to the program by 2030—require the consideration of MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). reforms in future years. MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). must remain a strong, broadly supported social insurance program Group insurance that serves a social purpose and is operated by the government. Individuals contribute to the program either directly or indirectly through their employer. Tax revenues may also be used to fund these programs. The program protects participants from large or sudden… so that it can continue to protect current and future generations.

The fiscal pressures facing MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). reflect the general trend in the overall health care market. Overall, health care spending has been growing faster than the overall economy for decades. Annual cost increases place upward pressure on premiums and expenditures for all payers, including MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). , other federal health programs, private plans, state insurance plans, and people who self-finance their care.

However, because of laws enacted to slow MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). growth—as well as steps taken by MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). , private plans, and other payers to restrain cost increases—substantial MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). savings have occurred in recent years. According to the MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). Board of Trustees, MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). spending per beneficiary had the lowest five-year growth rates from 2010 through 2015 since the program’s inception. Total MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). spending per beneficiary grew an average of 1.4 percent per year during these five years. Low per beneficiary spending growth continued in 2016 and 2017. As a result of slower spending growth, the 2018 MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). trustees’ report projected that the Hospital Insurance Trust Fund (Part A) would be solvent until 2026—nine years longer than was projected in 2009.

Despite slower spending during the past decade, MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). still faces long-term financial challenges that must be addressed. MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). must grapple with the enrollment growth associated with aging baby boomers and the related declining ratio of workers to beneficiaries. MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). enrollment is projected to increase from 58 million in 2017 to 80 million in 2030. We must find viable solutions to ensure adequate and affordable benefits while making the program sustainable for future generations.

There have been a number of proposals to address MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). ’s long-term sustainability. They include, among other changes, raising the eligibility age, converting MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). from a defined-benefit to a defined-contribution (voucher) system, means testing, altering the program’s financing structure, and privatizing the program.

Solutions to address MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). ’s long-term financial outlook should not simply shift costs to current and future MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). beneficiaries. Instead, a first step should look at ways to improve the program’s efficiency and integrity. Research literature documents that a significant portion of health care spending fails to yield better care and is therefore wasted. As part of the larger health care system, MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). must encourage the transformation of service delivery so that care is person-centered, efficient, and of high quality. Congress has already taken steps to help ensure these outcomes, such as by encouraging innovative payment and delivery models, but much more can be done.

Americans of all ages recognize MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). ’s role in helping to ensure financial security in retirement.

MEDICARE BENEFITS AND FINANCING: Policy

MEDICARE BENEFITS AND FINANCING: Policy

Equity

The MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). program should not be means-tested. Eligibility should not be based on income or assets.

Any major changes to MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). should first be evaluated in demonstrations or pilots. They should assess the effects of proposed changes on MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). costs, access to health care services, continuity of care, quality of care, beneficiary satisfaction, and beneficiaries’ out-of-pocket costs. Evaluations should take into consideration geographic location and socioeconomic differences.

The Centers for MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). & MedicaidA joint federal/state program that provides health care and LTSS. However, to qualify for Medicaid LTSS, people must have extremely low assets and income, or they have to “spend down” most of their assets. Services should work to eliminate racial, ethnic, and socioeconomic disparities in care.

Benefit adequacy and affordability

MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). ’s benefit package should continue to provide access to all covered services for all beneficiaries, without regard to income, geographic location, health status, or coverage option.

MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). should cover vision care (including eyeglasses), hearing care (including hearing aids), dental care, and long-term care, and guarantee coverage across the continuum of care.

MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). should protect beneficiaries from burdensome out-of-pocket costs and catastrophic health costs.

Program deductibles and coinsuranceA form of health care cost sharing in which a percentage of covered expenses must be paid by the insured. In contrast, a copayment is a specific dollar amount that must be paid for a specific service. should not vary by income or assets except to the extent that beneficiaries with low incomes may receive subsidies that ensure access and affordability.

MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). reforms should not shift burdensome financial risks to MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). beneficiaries.

The government’s share of MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). benefit costs must keep pace with the growth in those costs and not be tied to arbitrary budget targets.

Sustainability

The long-term cost growth in health care, including MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). , is unsustainable in part because MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). also faces substantial growth in enrollment. Therefore, reform is essential to strengthen and maintain the viability of the program.

To hold down MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). ’s costs and ensure its long-term solvency, the rate of cost growth throughout the health care system and within MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). must remain low. This can be done through payment and delivery system reforms that encourage higher-value care and discourage inappropriate use of services.

MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). financing should be broad-based, stable, and progressiveIn taxation, a situation in which people with lower income pay a smaller percentage of their income than do people with higher income. ; further public health objectives; and keep pace with enrollment.

Options for increasing revenues to support the program should be considered to ensure the program remains sustainable.

All MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). participants (beneficiaries, providers, suppliers, and plans) should contribute to its viability. Shared accountability will differ for providers, beneficiaries, and the program itself, but each should be responsible for ensuring the prudent use of MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). resources.

Access

The eligibility age for MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). should not be raised.

MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). beneficiaries should continue to have access to a choice of health coverage options, including a strong and viable Traditional MedicareTraditional Medicare, also known as Original or Fee-For-Service Medicare, works on a fee-for-service basis. This means that you can go to any doctor or hospital that accepts Medicare, anywhere in the United States, and Medicare will pay its share of the bill for any Medicare-covered service it… program administered by the government.

MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). payment rates to providers should be fair and encourage the efficient use of resources while maintaining beneficiaries’ access to affordable, high-quality care.

The current 24-month MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). waiting period for Social Security Disability Insurance recipients should be eliminated.

The Social Security Administration should continue to notify potential MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). beneficiaries several months before they reach MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). eligibility at age 65 about the steps to take if they want to enroll, the circumstances under which Part B premium penalties may be assessed, and the guaranteed issue period for purchasing a Medigap policy.

Quality and efficiency

MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). should discourage overuse, underuse, and misuse of health care services.

MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). should support efforts to improve care coordination, particularly for people with chronic conditions.
MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). must eliminate waste, fraud, and abuse to ensure appropriate use of program resources.

MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). should have statutory authority to use its purchasing power to obtain drug price discounts directly on behalf of beneficiaries.

MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). should be a leader in health care reform and a cooperative partner with other stakeholders (e.g., MedicaidA joint federal/state program that provides health care and LTSS. However, to qualify for Medicaid LTSS, people must have extremely low assets and income, or they have to “spend down” most of their assets. , states, private purchasers) in achieving an affordable, effective, and efficient health care system.

Traditional MedicareTraditional Medicare, also known as Original or Fee-For-Service Medicare, works on a fee-for-service basis. This means that you can go to any doctor or hospital that accepts Medicare, anywhere in the United States, and Medicare will pay its share of the bill for any Medicare-covered service it… and Medicare AdvantageMedicare Advantage (MA) health plans are offered by private Medicare approved companies as an alternative to Original Medicare. Medicare pays these companies a fixed amount per enrollee per month to provide benefits for Parts A, B, and (usually) D. plans should face the same or equivalent requirements for cost, quality, efficiency, and consumer protections.

The current form of payment for health care services in Traditional MedicareTraditional Medicare, also known as Original or Fee-For-Service Medicare, works on a fee-for-service basis. This means that you can go to any doctor or hospital that accepts Medicare, anywhere in the United States, and Medicare will pay its share of the bill for any Medicare-covered service it… (i.e., fee-for-service) should evolve to incentivize high-quality, efficient care rather than volume.

MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). should continually and systematically collect information on the program’s quality and efficiency. The results of its findings should be published.

MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). should be simple and transparent for beneficiaries and providers.

MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). should seek administrative efficiencies (see also Medicare Program Administration and Outreach).

MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). should take advantage of its position as a large purchaser of health services to obtain the best value.

MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). should rapidly test and evaluate the use of comprehensive geriatric assessment instruments.