What is Medicare?
Medicare is a program under the Centers for Medicare and Medicaid Services (CMS) that offers health insurance for individuals of 65 years of age or older in the U.S. Individuals living with end-stage renal disease and some younger individuals living with disabilities also qualify for Medicare. Once an individual turns 65 or becomes eligible in another way, they can enroll in Medicare and choose between Original Medicare or Medicare Advantage.
Medicare has four parts that cover different healthcare services:
Medicare Part A: hospital insurance
Medicare Part B: medical insurance
Medicare Part C: Medicare Advantage
Medicare Part D: coverage for prescription drugs
Individuals can elect to have health insurance under Medicare in addition to another insurance provider. In these cases, the individuals have “multiple payors.”
The Hospital Insurance (HI) Trust Fund and the Supplementary Medical Insurance (SMI) Trust Fund finance Medicare.
Why is Medicare important to healthcare?
Medicare is critically important because it offers high-quality and affordable healthcare services to 60 million younger individuals living with disabilities and older individuals. Medicare helps fund medications, hospitalizations, preventive services, hospice care, skilled nursing facility care, physician visits and home health care visits for these individuals.
Definitive Healthcare’s intelligence features claims data from Medicare Part A, Medicare Part B and Medicare Part D.