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Government Programs

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Centers for Medicare & Medicaid Services (CMS)

CMS is the federal agency which administers Medicare, Medicaid, and the Children's Health Insurance Program; is a branch of the U.S. Department of Health and Human Services.

  • Medicare provides health coverage to people age 65 or older, people under age 65 with certain disabilities, and people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).
  • Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities. Medicaid programs must follow federal guidelines, but they vary from state to state.
  • Children’s Health Insurance Program (CHIP) provides free or subsidized health coverage for eligible children. CHIP is part of Medicaid in many states.

Individuals in the U.S. seeking medical coverage, health professionals

877-267-2323 http://www.cms.gov

HealthCare.gov

To host health insurance marketplaces and to provide consumers with information on the Patient Protection and Affordable Care Act (ACA).

  • Provides information about health insurance options in each state’s health insurance Marketplace
  • Provides information about financial assistance options to purchase insurance in Marketplaces

Individuals, families and small businesses looking for information about health insurance options

800-318-2596 http://www.healthcare.gov

Hill-Burton Free and Reduced-Cost Health Care

In 1946, Congress passed a law that gave hospitals, nursing homes and other health facilities grants and loans for construction and modernization. In return, they agreed to provide a reasonable volume of services to persons unable to pay and to make their services available to all persons residing in the facility’s area. The program stopped providing funds in 1997, but about 170 health care facilities nationwide are still obligated to provide free or reduced-cost care. Since 1980, more than $6 billion in uncompensated services have been provided to eligible patients through Hill-Burton.

  • Free and reduced-cost health care is available to people who cannot afford to pay at Hill-Burton obligated facilities
  • Hill-Burton assisted facilities include hospitals, nursing homes, and other health care facilities
  • Hill-Burton facilities determine which services are provided free of charge or at reduced costs
  • The program only covers facility costs; it does not cover private physician bills.

Patients in need of care whose income must fall within the annually published Poverty Guidelines.

800-638-0742 (800-492-0359 in Maryland) https://www.hrsa.gov/get-health-care/affordable/hill-burton/

Insure Kids Now / U.S. Department of Health & Human Services

InsureKidsNow.gov provides information about Medicaid and Children’s Health Insurance Program (CHIP) services for families who need health insurance coverage. These programs are designed to be affordable for families who are not able to afford health insurance coverage in the private market or do not have coverage available to them.

  • CHIP provides free or low-cost health coverage for children up to age 19; CHIP covers U.S. citizens and eligible immigrants.
  • Each state designs its own CHIP, including eligibility, benefits, premiums and cost-sharing, and application and renewal procedures
  • States have different income eligibility guidelines, but in most states, uninsured children 18 years old and younger whose family incomes are up to $45,000 per year (for a family of four) can qualify for either Medicaid or CHIP. In many states, family income can be even higher and children can still qualify.

Families in the U.S. seeking health insurance coverage

877-543-7669 http://www.insurekidsnow.gov

Medicare

Provides government-funded healthcare coverage to specific populations of need. It may include both medical and drug coverage. Medicare is divided into the following parts:

  • Part A Hospital Insurance helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits. Most people don't pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working.
  • Part B Medical Insurance helps cover doctors' services and outpatient care. It also covers some other medical services that Part A doesn't cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary. Most people pay a monthly premium for Part B.
  • Part C Medicare Advantage Plan - These are plans approved by Medicare and run by private companies that provide Part A and Part B coverage, and may offer extra coverage (such as vision, hearing, dental) and may include Part D prescription drug coverage.
  • Part D Prescription Drug Coverage – Part D provides coverage to enrollees for brand-name and generic prescription drugs. Patients must elect and enroll in a plan and generally pay a monthly premium and yearly deductible.

People age 65 or older, people under age 65 with certain disabilities, and people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant)

800-633-4227 http://www.medicare.gov

Social Security Administration (SSA)

To administer national Social Security programs as prescribed by legislation in an equitable, effective, efficient, and caring manner.

  • Provides a safety net for the public and contributes to increased financial security for the elderly and disabled.
  • Programs include Social Security Disability, Supplemental Security Income, Retirement Benefits, Survivor Benefits and Medicare.

Aged or disabled workers, their spouses and children in the U.S.

800-772-1213 http://www.ssa.gov

Veterans Health Administration

To honor America's veterans by providing exceptional health care that improves their health and well-being.

  • Provides comprehensive health care and support services through a system of medical centers, outpatient clinics, community living centers and vet centers.

U.S. military veterans

800-827-1000 http://www.va.gov/health