Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:Introduction to Health Care and Public Health in the U.S.
Unit:Delivering Health Care - Part 1
Lecture:Organization of Health Care and the Federal, State, and Local Levels
Slide content:Centers for Medicare and Medicaid Services (CMS) Provides insurance for 1 in 4 Americans Medicare Largest health insurer in the U.S. For people 65+ or disabled people Insured person pays premiums Medicaid For low-income patients and families Specific guidelines are determined by each state Insured person generally does not pay Children s Health Insurance Program 14
Slide notes:The Centers for Medicare and Medicaid Services, or CMS, provides health care insurance for one in every four Americans. In fact, Medicare is the largest health insurer in the U.S., processing more than one billion claims every year. Medicare is for people aged 65 and older, along with younger people who have certain disabilities. Medicare insurance is divided into four parts: Part A, which is hospital insurance; Part B, which is medical insurance; Part C, or Medicare Advantage, which allows the use of private companies approved by Medicare, or provider organizations; and Part D, which is prescription drug coverage. The insured person may pay monthly premiums depending on the plan selected. Medicaid is a health insurance program targeted at low-income individuals and families who meet specific requirements. The eligibility rules and the services provided vary by state. Medicaid reimburses the medical provider directly, although some states require the patient to contribute a small co-payment. Another division of CMS is the Childrens Health Insurance Program, or CHIP. It serves uninsured children and pregnant women who do not qualify for Medicaid but cannot afford private health care insurance. 14