The Centers for Medicare and Medicaid Services is part of the Department of Health and Human Services (HHS). CMS manages Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the insurance marketplace. CMS is “tasked with strengthening and modernizing the nation’s health care system…” as well as managing public funds. Their vision, or goal, is a high-quality health care system that facilitates better access to coverage and improved health for Americans. As of now, roughly one in three Americans is enrolled in one of the CMS programs.

Medicare
Serves
  • 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).

For more information, click here.

Medicaid

Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements.  The program is funded jointly by states and the federal government. In order to be eligible for Medicaid, federal law requires states to cover certain groups of individuals. Low-income families, qualified pregnant women and children, and individuals receiving Supplemental Security Income (SSI) are examples of mandatory eligibility groups. States have additional options for coverage and may choose to cover other groups, such as individuals receiving home and community-based services and children in foster care who are not otherwise eligible.


For more information on the program and its functions, click here.  

Children’s Health Insurance Program (CHIP)

The Children’s Health Insurance Program (CHIP) provides health coverage to eligible children, through both Medicaid and separate CHIP programs. Like Medicaid, CHIP is administered by states according to federal requirements, and the program is funded jointly by the federal government and the states. Benfits included in the program vary by state and CHIP program-type.

For more information, click here

Review CMS’ organization and structure below:


[Source: CMS.gov, “About CMS” https://www.cms.gov/About-CMS/About-CMS.html ]

[Source: CMS.gov, “About CMS” https://www.cms.gov/About-CMS/About-CMS.html ]

[Source: CMS.gov “Medicare – General Information” https://www.cms.gov/Medicare/Medicare-General-Information/MedicareGenInfo/index.html ]

[Source: Medicaid.gov – Overview https://www.medicaid.gov/medicaid/index.html ]

[Source: Medicaid.gov – Eligibility https://www.medicaid.gov/medicaid/eligibility/index.html ]

[Source: Medicaid.gov – CHIP: Benefits https://www.medicaid.gov/chip/benefits/chip-benefits.html ]