Medicare is a federally administered health insurance program for people 65 years of age or older, certain disabled individuals that have been receiving Social Security Disability Insurance for 24 months, and for people with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant). Medicare was created as part of the Social Security Act of 1965, and currently provides benefits to over 40 million people. Click here to view a brief overview of the Medicare program prepared by the Centers for Medicare and Medicaid Services, the federal agency that administers the Medicare program.

Effective January 1, 2006, Medicare will begin providing outpatient prescription drug benefits to beneficiaries for the first time in the history of the program. Drug coverage and benefit design varies according to the Part D plan selected. Each year, Medicare beneficiaries may elect to sign up for a Medicare plan that includes Part D coverage. During this inaugural year, the open enrollment period runs through May 15, 2006. Additional information is available at www.Medicare.gov and through the Centers for Medicare and Medicaid Services.

Medicare also covers physician-administered drugs and vaccines through Medicare parts A and B. The following links provide useful information about drug coverage under Medicare parts A, B, and D.

Medicare General

• Centers for Medicare and Medicaid Services - Home
• Medicare.Gov

Part D Prescription Drug Coverage

• Compare Medicare Drug Plans - Prescription Drug Plan Finder
• Landscape of Local Drug Plans
• Medicare Drug Formulary Finder
• Prescription Drug Coverage - General Information

Part B Fee For Service Drugs

• Competitive Acquisition Program for Part B Drugs & Biologicals
• Historical Part B Drug Pricing Files
• Medicare Part B Drugs Average Sales Price
• Medicare Part B Carrier Websites

Medicare Coverage and Policy

• Medicare Coverage Center
• Medicare Coverage Database
• Medicare Coverage Determination Process
• Medicare Coverage Guidance Documents
• Medicare Clinical Trial Policies
• CMS Manual System
• Medicare Benefit Policy Manual
• Medicare Benefit Policy Manual - Chapter 15 - Covered Medical and Other Health Services (includes Drugs)
• Medicare National Coverage Determinations Manual
• Medicare Claims Processing Manual
• Medicare Claims Processing Manual - Chapter 17 - Drugs and Biologicals

Medicare Payment Systems

• Fee Schedules - General Information
• Prospective Payment Systems - General Information
• Acute Inpatient PPS
• Hospital Outpatient PPS
• Physician Fee Schedule

Healthcare Common Procedure Coding System (HCPCS) Coding

• HCPCS - General Information
• HCPCS Release & Code Sets