Abstract
Upon completion of the chapter, the student will be able to:
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1.
Distinguish between Medicare and Medicaid.
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2.
Know the significance of Medicare Parts A, B, C, and D and the coverage provided by each.
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3.
Identify who is eligible for Medicare and how it is obtained.
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4.
Understand the role of Medicare Supplemental Insurance Plans and Medicare Health Maintenance Organization (HMO).
Material in this chapter is based on the following chapter in Cassel CK, Leipzig RM, Cohen HJ, Larson EB, Meier DE, eds. Geriatric Medicine: An Evidence-Based Approach, 4th ed. New York: Springer, 2003: Vladeck BC. Mechanisms of Paying for Health Care, pp. 1201–1211.
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Suggested Readings
Center for Medicare and Medicaid Services web page: http://www.cms.gov. This Web site answers all questions regarding both Medicare and Medicaid. The site is divided into sections for the public and for providers.
Gallagher P, Smith S. Medicare: The Physician’s Guide, 2002. Chicago: American Medical Association, 2002. An excellent resource for the practicing physician, this guide offers detailed explanations of the billing and reimbursement process.
Vladeck BC. Sounding board: plenty of nothing—a report from the Medicare Commission. N Engl J Med 1999;340:1503–1506.
Vladeck BC. The storm before the calm before the storm: Medicare home care in the wake of the Balanced Budget Act. Care Manage J 2000;2(4):232–237.
Vladeck BC. Mechanisms of paying for health care. In: Cassel CK, Leipzig RM, Cohen HJ, et al., eds. Geriatric Medicine, 4th ed. New York: Springer, 2003:1201–1212.
References
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Annual Report of the Board of Trustees of the Federal Hospital Insurance Trust Fund. Washington, DC: Government Printing Office, April 24, 1997.
Annual Report of The Board of Trustees of the Federal Hospital Insurance Trust Fund (corrected). Washington, DC: Government Printing Office, April 20, 2000.
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Ridge, S.B. (2007). Medicare and Medicaid. In: Soriano, R.P., Fernandez, H.M., Cassel, C.K., Leipzig, R.M. (eds) Fundamentals of Geriatric Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-32326-8_5
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