Wis. ForwardHealth Online Handbook, Hospice, Topic #672

Medicare is a health insurance program for people 65 years of age or older, for certain people with disabilities under age 65, and

for people with ESRD (end-stage renal disease). Medicare is a federal government program created under Title XVIII of the

Social Security Act.

Medicare coverage is divided into four parts:

• Part A (Hospital Insurance). Part A helps to pay for medically necessary services, including inpatient hospital services,

services provided in critical access hospitals (for example, small facilities that give limited inpatient services and outpatient

services to beneficiaries who reside in rural areas), services provided in skilled nursing facilities, hospice services, and some

home health services.

• Part B (Supplemental Medical Insurance). Part B helps to pay for medically necessary services, including physician

services, outpatient hospital services, and some other services that Part A does not cover (such as PT (physical therapy)

services, OT (occupational therapy) services, and some home health services).

• Part C (Medicare Advantage). A commercial health plan that acts for Medicare Parts A and B, and sometimes Medicare

Part D, for all Medicare covered services except hospice. Medicare Part A continues to provide coverage for hospice

services. There are limitations on coverage outside of the carrier's provider network.

• Part D (drug benefit).