- Отрасли: Government
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The federal agency that runs the Medicare program. In addition, CMS works with the States to run the Medicaid program. CMS works to make sure that the beneficiaries in these programs are able to get high quality health care.
Time when an eligible person may choose to join or leave the Original Medicare Plan or a Medicare+Choice plan. There are four types of election periods in which you may join and leave Medicare health plans: Annual Election Period, Initial Coverage Election Period, Special Election Period, and Open Enrollment Period.
* Annual Election Period: The Annual Election Period is the month of November each year. Medicare health plans enroll eligible beneficiaries into available health plans during the month of November each year. Starting in 2002, this is the only time in which all Medicare+Choice health plans will be open and accepting new members.
* Initial Coverage Election Period: The three months immediately before you are entitled to Medicare Part A and enrolled in Part B. If you choose to join a Medicare health plan during your Initial Coverage Election Period, the plan must accept you. The only time a plan can deny your enrollment during this period is when it has reached its member limit. This limit is approved by the Centers for Medicare & Medicaid Services. The Initial Coverage Election Period is different from the Initial Enrollment Period (IEP).
* Special Election Period: You are given a Special Election Period to change Medicare+Choice plans or to return to Original Medicare in certain situations, which include: You make a permanent move outside the service area, the Medicare+Choice organization breaks its contract with you or does not renew its contract with CMS; or other exceptional conditions determined by CMS. The Special Election Period is different from the Special Enrollment Period (SEP).
* Open Enrollment Period: If the Medicare health plan is open and accepting new members, you may join or enroll in it. If a health plan chooses to be open, it must allow all eligible beneficiaries to join or enroll.
Industry:Insurance
The way that Medicare measures your use of hospital and skilled nursing facility (SNF) services. A benefit period begins the day you go to a hospital or skilled nursing facility. The benefit period ends when you haven?t received any hospital care (or skilled care in a SNF) for 60 days in a row. If you go into the hospital or a skilled nursing facility after one benefit period has ended, a new benefit period begins if you are in the Original Medicare Plan. You must pay the inpatient hospital deductible for each benefit period. There is no limit to the number of benefit periods you can have.
Industry:Insurance
要確定各個提供程式時提供給受益人所涉的服務的合理費用計算。的合理成本基於提供此類服務，包括供應商，直接和間接費用的實際費用並不包括任何不必要的高效率提供服務的費用由健康保險程式所涵蓋。
Industry:Insurance
1994 年 8 月 15 日，關於社會保障獨立和 1994 年 (公法 103-296) 程式改進法 》 頒佈之前社會保險法 》 須委任諮詢理事會每隔 4 年，研究和審查的 OASDI 和醫療保險的程式的財務狀況。于 1994 年 6 月 9 日，委任，最新諮詢理事會和日 1997 年 1 月 6 日提交了其報告的 OASDI 程式的財務狀況。的公法 103-296，規定這是上次諮詢理事會任命。
Industry:Insurance
委員會由 1997 年的平衡預演算法案在國會設立，以取代准支付評估委員會和醫生支付審查委員會。MedPAC 被針對向國會提供諮詢意見和提出有關醫療保健計畫的政策建議。
Industry:Insurance
聾、 聽力障礙，或者有嚴重語言障礙的人所使用的通信設備。A TTY 包括鍵盤、 顯示幕幕和數據機。普通電話線 消息旅行。愛的人? t 具有 TTY 可以通過郵件中繼中心 （MRC） TTY 使用者進行溝通。MRC 有 TTY 運算子可用來發送和解釋 TTY 消息。
Industry:Insurance
醫療保險承辦商收集和管理資訊，對其他類型的保險或覆蓋以前醫療保險, 支付。其他類型的保險或覆蓋範圍的一些示例包括： 集團健康保險、 退休人員覆蓋面，工人嗎？補償，無過失或責任保險、 退伍軍人嗎？福利、 TRICARE、 聯邦黑肺程式和眼鏡蛇。
Industry:Insurance
每個期間的一項計畫，將確保最大的美元數額。這是唯一適用服務類別為凡有增強福利提供的這項計畫，因為醫療保險覆蓋面不允許最大計畫受益覆蓋開支限制。
Industry:Insurance
