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During
this seminar, we discussed the key elements of the Medicare Program.
- SSA enrolls people
in the Medicare Program, and then CMS administers Medicare benefits
and services.
- Medicare is
a health insurance program for people age 65 and older, some people
with disabilities, and people with ESRD.
- The Medicare Program consists of three parts: Part A (Hospital
Insurance), Part B (Medical Insurance), and prescription drug coverage.
- The Medicare
Program includes the following coverage options: Original Medicare
Plan, Medicare Advantage, and other Medicare Health Plans.
- Medicare Advantage Plans may cost less than the Original Medicare
Plan and may offer more benefits.
- Assignment is
an agreement between Medicare and doctors, other health care providers,
and suppliers to accept the Medicare-approved amount as payment in full.
- Providers who
provide Medicare-covered services for persons with Medicare
but do not accept
assignment cannot charge more than 115% of the Medicare-approved amount
for those services.
- The Medicare
Program will not pay for services provided under a private contract
between a provider and a person with Medicare.
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