Medicare is the federal health insurance program for people aged 65 or older and certain younger people with disabilities.
Medicaid is a joint federal and state program that helps pay medical costs for people with limited income who meet certain eligibility criteria. Medicaid also offers financial assistance for nursing home and personal care services. Every state has different rules for Medicaid.
There have been no changes to our participation in Medicare and Medicaid programs. Patient’s coverage should be the same as it was prior to the publication of the recent news article. You can find our full statement here.
CMS has the right and responsibility to survey any hospital participating in Medicare and Medicaid programs and we welcome their review as we are committed to continuing to provide a safe environment for all of our patients and families. Our organization is not on a pathway to termination from Medicare and Medicaid programs.
Medicare Part A, or Hospital Insurance, covers hospital stays, hospice care, skilled nursing facilities, and some home health care.
Medicare Part B, or Medical Insurance, covers doctor visits, preventive care and screening, and medical supplies.
Medicare Parts A and B are both accepted at MD Anderson.
Medicare Part C, also known as the Medicare Advantage Plan, replaces traditional Medicare. Kelsey-Care Medicare Advantage is the only Medicare Advantage plan with which MD Anderson is contracted. However, we have a working relationship with some Medicare Advantage HMO and PPO plans. Please contact your plan to determine if they will work with MD Anderson.
Medicare Supplemental (MediGap) policies allow enrollees to see any provider that accepts Medicare. Some of these supplemental plans are accepted at MD Anderson. However, we do not accept any supplemental plans that require enrollees to use a provider in a restricted network that does not include MD Anderson or its physicians.
Traditional Texas Medicaid is accepted at MD Anderson. You must select a Managed Medicaid plan within within 30-45 days, or one will be chosen for you by Texas Medicaid. Traditional Texas Medicaid does not include Managed Medicaid HMO plans.
Managed Medicaid HMO plans are managed by a health insurance company. MD Anderson is only contracted with Texas Children’s Health plan, STAR and Children’s Health Insurance Program (CHIP). Some non-contracted health plans allow treatment at MD Anderson through a single case agreement process. Please contact your health plan and ask if they are willing to negotiate a single case agreement to allow treatment at MD Anderson.
Out-of-State Medicaid: MD Anderson does not accept out-of-state traditional Medicaid or Managed Medicaid plans.