Statements (411)
| Predicate | Object |
|---|---|
| gptkbp:instance_of |
gptkb:health_services
gptkb:Health_Insurance |
| gptkbp:administered_by |
gptkb:Centers_for_Medicare_&_Medicaid_Services
gptkb:Centers_for_Medicare_&_Medicaid_Services_(CMS) gptkb:federal_government private insurance companies U. S. states |
| gptkbp:amended_by |
from year to year
|
| gptkbp:application |
state application process
|
| gptkbp:beneficiary |
over 60 million
Over 60 million |
| gptkbp:benefits |
gptkb:transportation_services
rehabilitation services millions of Americans prescription drugs long-term care prescription drug coverage dental services hospital insurance medical insurance vision services |
| gptkbp:can_be |
a cost-effective option
a managed care plan HMO or PPO a PPO plan an HMO plan |
| gptkbp:can_include |
gptkb:Medicare_Part_D
gptkb:fitness_classes telehealth services dental coverage home health services vision coverage hearing coverage |
| gptkbp:can_provide |
chronic care management
additional wellness services |
| gptkbp:challenges |
access to care
rising costs funding sustainability |
| gptkbp:controversy |
funding issues
eligibility restrictions expansion debates |
| gptkbp:country |
gptkb:United_States
|
| gptkbp:cover_version |
long-term care
|
| gptkbp:coverage |
preventive services
prescription drug coverage certain younger people with disabilities people aged 65 and older People aged 65 and older hospital insurance medical insurance people with End-Stage Renal Disease dialysis services people with End-Stage Renal Disease (ESRD) |
| gptkbp:covers |
gptkb:children
gptkb:emergency_services Medical services disabled individuals elderly pregnant women prescription drug coverage urgent care services hospital insurance hospital stays medical insurance Hospital insurance |
| gptkbp:created_by |
gptkb:U._S._Congress
gptkb:1965 gptkb:Social_Security_Act_amendments |
| gptkbp:decided_by |
millions of Americans
|
| gptkbp:effective_date |
annual renewal
|
| gptkbp:eligibility |
gptkb:disease
age disability income level specific medical conditions certain disabilities disability status end-stage renal disease End-Stage Renal Disease age 65 or older Age 65 or older U. S. citizenship or legal residency age or disability ESRD status Citizens and legal residents age, disability, or health condition |
| gptkbp:enacted_by |
gptkb:Social_Security_Act_of_1965
July 30, 1965 |
| gptkbp:established |
gptkb:1965
|
| gptkbp:established_in |
gptkb:U._S._Congress
gptkb:1965 gptkb:Social_Security_Act |
| gptkbp:expansion |
gptkb:Affordable_Care_Act
|
| gptkbp:financial_aid |
low-income beneficiaries
Medicaid integration |
| gptkbp:has |
network restrictions
|
| gptkbp:has_a_coverage_gap |
in Part D
|
| gptkbp:has_a_coverage_gap_known_as |
the donut hole
|
| gptkbp:has_a_deductible |
for Part A
|
| gptkbp:has_a_deductible_for |
gptkb:Part_A
|
| gptkbp:has_a_premium |
for Part B
|
| gptkbp:has_cost_sharing |
deductibles
coinsurance copayments |
| gptkbp:has_different_plans |
gptkb:Medicare_Advantage
|
| gptkbp:has_enrollment_periods |
for beneficiaries
|
| gptkbp:has_impact_on |
gptkb:healthcare_access
healthcare costs health outcomes healthcare quality |
| gptkbp:has_limitations |
out-of-pocket costs
coverage gaps |
| gptkbp:has_part |
gptkb:Original_Medicare
gptkb:Part_A gptkb:Part_B gptkb:Part_C gptkb:Part_D |
| gptkbp:has_programs |
gptkb:Children's_Health_Insurance_Program_(CHIP)
gptkb:Medicare gptkb:Medicaid preventive services CHIP Marketplace insurance |
| https://www.w3.org/2000/01/rdf-schema#label |
Medicare
|
| gptkbp:impact |
improves health outcomes
reduces financial burden reduces uninsured rates |
| gptkbp:includes |
gptkb:Medicare_Part_B
gptkb:Medicare_Part_A gptkb:Part_A gptkb:Part_B gptkb:Part_C gptkb:Part_D skilled nursing facility care annual wellness visit |
| gptkbp:includes_parts |
gptkb:Part_A
gptkb:Part_B gptkb:Part_C gptkb:Part_D |
| gptkbp:includes_preventive_services |
vaccinations
annual wellness visits screening tests |
| gptkbp:introduced_in |
gptkb:1965
|
| gptkbp:is |
the same as Original Medicare
|
| gptkbp:is_a_choice_for |
healthcare coverage
|
| gptkbp:is_a_federal_program |
gptkb:true
with state participation |
| gptkbp:is_affected_by |
demographic changes
economic conditions |
| gptkbp:is_associated_with |
chronic conditions
healthcare quality healthcare disparities healthcare access issues healthcare utilization |
| gptkbp:is_available_in |
gptkb:United_States
gptkb:citizens Elderly undocumented immigrants all states permanent residents most states dual eligible beneficiaries U. S. territories all U. S. states legal residents of the U. S. permanent residents after 5 years people eligible for Medicare |
| gptkbp:is_challenged_by |
insurance companies
market competition legal challenges political opposition healthcare reform proposals budget cuts |
| gptkbp:is_connected_to |
gptkb:health_services
gptkb:Medicaid gptkb:Social_Services Medicaid expansion healthcare funding healthcare innovation private insurance plans healthcare reform efforts |
| gptkbp:is_considered |
a social insurance program
a federal program a public health program Entitlement program a model for universal healthcare a social safety net program a vital program for seniors |
| gptkbp:is_criticized_for |
complexity
political opponents costs out-of-pocket costs fraud and abuse coverage gaps rising costs complexity of enrollment process high out-of-pocket costs variability in coverage options Cost control issues |
| gptkbp:is_designed_for |
seniors
elderly and disabled individuals |
| gptkbp:is_designed_to |
reduce healthcare costs
improve health outcomes coordinate care simplify healthcare access help older adults |
| gptkbp:is_different_from |
gptkb:Medicaid
private health insurance |
| gptkbp:is_essential_for |
Healthcare access
|
| gptkbp:is_evaluated_by |
gptkb:government_agency
gptkb:Centers_for_Medicare_&_Medicaid_Services gptkb:Congressional_Budget_Office gptkb:Medicare_Payment_Advisory_Commission financial sustainability cost-effectiveness quality of care patient satisfaction member satisfaction independent auditors government audits healthcare researchers health policy analysts star ratings health economists independent studies |
| gptkbp:is_funded_by |
gptkb:Federal_Insurance_Contributions_Act_(FICA)_taxes
gptkb:federal_government payroll taxes federal and state governments Payroll taxes beneficiary premiums general revenue Medicare and member premiums |
| gptkbp:is_influenced_by |
gptkb:political_debates
gptkb:public_opinion demographic changes economic factors economic conditions healthcare policies legislative changes political climate political factors political decisions healthcare policy changes local market conditions |
| gptkbp:is_linked_to |
gptkb:Affordable_Care_Act
gptkb:healthcare_access gptkb:Medicaid gptkb:Social_Services aging population healthcare policy discussions healthcare costs health outcomes Social Security benefits healthcare outcomes healthcare innovation |
| gptkbp:is_monitored_by |
gptkb:health_services
gptkb:United_States_Congress gptkb:Centers_for_Medicare_&_Medicaid_Services gptkb:lawyer gptkb:Centers_for_Medicare_&_Medicaid_Services_(CMS) |
| gptkbp:is_not_means-tested |
gptkb:true
for eligibility |
| gptkbp:is_often_compared_to |
Medigap plans
|
| gptkbp:is_often_seen_in |
gptkb:Medicaid
|
| gptkbp:is_part_of |
gptkb:Affordable_Care_Act
gptkb:Social_Security_Act gptkb:Social_Services public health initiatives national health policy healthcare reform discussions healthcare delivery system U. S. healthcare system U. S. social insurance programs U. S. social insurance system U. S. social safety net the Medicare program the Affordable Care Act provisions |
| gptkbp:is_popular_among |
Medicare beneficiaries
|
| gptkbp:is_popular_for |
retirees.
its additional benefits |
| gptkbp:is_promoted_by |
gptkb:government_officials
gptkb:healthcare_professionals gptkb:politicians government initiatives non-profit organizations healthcare advocates healthcare organizations public health campaigns government campaigns patient advocacy organizations senior organizations |
| gptkbp:is_promoted_through |
public awareness campaigns
|
| gptkbp:is_regulated_by |
gptkb:Centers_for_Medicare_&_Medicaid_Services
|
| gptkbp:is_related_to |
gptkb:Affordable_Care_Act
gptkb:Medicaid |
| gptkbp:is_reviewed_by |
gptkb:government_agency
|
| gptkbp:is_similar_to |
gptkb:Medicaid
|
| gptkbp:is_subject_to |
state regulations
federal regulations legislative changes regulatory oversight policy reforms budget constraints legislation changes annual enrollment periods annual budget reviews cost-sharing requirements Annual adjustments annual budget review annual adjustments federal oversight. annual changes in coverage fraud and abuse concerns annual changes in deductibles annual changes in premiums fraud and abuse laws annual cost-sharing limits |
| gptkbp:is_supported_by |
non-profit organizations
research studies community organizations healthcare providers advocacy groups patient advocacy groups |
| gptkbp:is_used_by |
healthcare providers
millions of Americans |
| gptkbp:known_as |
gptkb:Part_C
|
| gptkbp:legislation |
gptkb:Medicare_Modernization_Act
gptkb:Medicare_Prescription_Drug,_Improvement,_and_Modernization_Act gptkb:Affordable_Care_Act gptkb:Bipartisan_Budget_Act gptkb:Medicare_Part_D gptkb:Medicare_Improvement_for_Patients_and_Providers_Act gptkb:Medicare_Access_and_CHIP_Reauthorization_Act gptkb:Medicare_Advantage_Program gptkb:Medicare_Part_C Medicare Savings Programs Medicare for All proposals Medicare Buy-In proposals Medicare Coverage of COVID-19 Vaccines Medicare Expansion proposals Medicare Telehealth Expansion |
| gptkbp:managed_care |
Medicaid managed care organizations
|
| gptkbp:may_have |
prior authorization requirements
higher out-of-pocket costs lower premiums than Original Medicare |
| gptkbp:number_of_players |
varies by state
largest source of health coverage in the U. S. over 70 million beneficiaries significant portion of state budgets |
| gptkbp:offers |
preventive services
additional benefits special needs plans supplemental insurance options |
| gptkbp:offers_supplemental_plans |
Medigap
|
| gptkbp:opening_date |
July 30, 1965
|
| gptkbp:provides |
health coverage
preventive services without cost-sharing financial assistance for healthcare home health care services health coverage for people aged 65 and older Health coverage health coverage for certain younger people with disabilities health coverage for people over 65 |
| gptkbp:provides_access_to |
private insurance companies
|
| gptkbp:provides_preventive_services |
vaccinations
annual wellness visits screening tests annual wellness visit |
| gptkbp:reformed |
gptkb:Affordable_Care_Act
|
| gptkbp:requires |
rehabilitation services
monthly premiums preventive care services long-term care services coinsurance copayments enrollment enrollment in Medicare home health services certain medical services |
| gptkbp:requires_premium_payment_for |
gptkb:Part_B
|
| gptkbp:requires_premiums_for |
gptkb:Part_B
gptkb:Part_D |
| gptkbp:services_provided |
mental health services
hospital services physician services preventive services substance use disorder services home health services nursing facility services |
| gptkbp:signed_by |
gptkb:Lyndon_B._Johnson
|
| gptkbp:state_variation |
state-specific programs
|
| gptkbp:student_enrollment |
Special Enrollment Period
open enrollment period General Enrollment Period Initial Enrollment Period Open Enrollment Period annual enrollment period initial enrollment period special enrollment period annual open enrollment mandatory for Part A voluntary for Part B |
| gptkbp:target_audience |
low-income individuals
certain younger people with disabilities people aged 65 and older people with End-Stage Renal Disease |
| gptkbp:type |
federal health insurance
|
| gptkbp:type_of |
managed care insurance
|
| gptkbp:bfsParent |
gptkb:U._S._government
|
| gptkbp:bfsLayer |
2
|