Centers for Medicare Services: Providing Oversight for Medicare Plans

Part of the United States Department of Health and Human Services, the Center for Medicare Services is charged with ensuring that Medicare patients receive the best possible health care coverage for themselves and their beneficiaries. The agency is responsible for administering Medicare, Medicaid, and the State Children’s Health Insurance Programs as well as taking the lead in simplifying the administrative requirements of the Insurance Portability and Accountability Act and enforcing standards for long-term nursing homes and clinical laboratories throughout the country.

Each office of the Center for Medicare Services is charged with administering the Medicare programs in their area. This includes Part A coverage as well as optional Part B and prescription drug coverage. Part A Medicare coverage is the basic plan that covers all members and offers basic health care benefits for most senior citizens. Once the deductible amount has been paid, Medicare Part A provides coinsurance benefits that pay a portion of the costs for covered hospital stays and inpatient care at a skilled nursing facility. Part B typically requires members to pay an additional premium, and covers outpatient care, occupational and physical therapy, routine doctor visits and preventive medicine, and home health care visits. Centers for Medicare and Medicaid Services administer the benefits for these government-sponsored plans.

Medicare Part C plans are offered by government-approved contractors who provide both Part A and Part B coverage to members. The coverage requires premiums which vary depending on the provider, and offers the same benefits as the combination of Medicare Part A and Part B plans. Additionally, Part D plans offer prescription drug coverage to complement Part A, B, or C plans. Not all medications are covered, and an additional premium payment is required for Part D coverage. While the Center for Medicare Services provides oversight for all these programs, they do not directly offer Part C plans. This can lead to significant differences in the monthly premiums and the additional benefits provided, so members will want to carefully read over the plan proposals before selecting a Plan C provider for their Medicare coverage.