Medicare

A significant percentage of California consumers who utilize California's county mental health services are eligible for or enrolled in the federal Medicare health insurance program.

In addition to administering the health insurance program for individuals, the Centers for Medicaid and Medicare Services (CMS) also administers and regulates the practice of various health care providers, including California county mental health department providers that bill for Medicare services.

Background Information on Medicare

Medicare is the federal health insurance program that offers health care coverage to individuals who qualify for Social Security and:  have reached retirement age (age 65 years or older); are under 65 years of age and have a  disability; or have End-Stage Renal Disease. There are four types of Medicare health care coverage:

• Part A, Hospital Insurance;
• Part B, Medical Insurance;
• Part C (Medicare Advantage) plans, which allow beneficiaries to choose to receive all of their health care services through a provider organization such as an HMO. (Note: Individuals must have both Parts A and B to enroll in Part C);
• Part D, Prescription Drug Coverage.

Regulatory Issues

• Deficit Reduction Act of 2005
• CMHDA Position Papers on Medicare Regulations

Other Advocacy Organizations Monitoring CMS' Medicare Regulations

• The Center for Medicare Advocacy
• The National Alliance for the Mentally Ill
• The National Association of County Behavioral Health Directors

Agencies

• Centers for Medicare and Medicaid Services

For More Information

• Don Kingdon, PhD – Deputy Director & Small Counties Liaison
  Contact for Medi-Cal and other regulatory issues.
  dkingdon@cmhda.org
• Erin Riggs, MSW – Associate Director, Legislation & Public Policy
  Contact for state legislation and public policy issues.
  eriggs@cmhda.org