Originally published January 17, 2019. Payer rules change; confirm current CMS and payer requirements before billing.
Medicare is health insurance for people 65 or older, certain people under 65 with disabilities, and people of any age with end-stage renal disease (ESRD).
The four parts of Medicare
- Part A, hospital insurance: inpatient hospital care, inpatient skilled nursing facility care, hospice care and some home health services
- Part B, medical insurance: physician services, outpatient care, durable medical equipment, home health services and many preventive services
- Part C, Medicare Advantage: Medicare-approved private insurers provide all Part A and Part B services, and may add prescription drug coverage and other benefits
- Part D, prescription drug benefit: Medicare-approved private companies provide outpatient prescription drug coverage
More information: CMS, Medicare beneficiaries and dual eligibles at a glance.