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Medicare General Information, Eligibility, and Entitlement
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Chapter 1 -
General Overview
Rev. 94, 10-16-2015
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Chapter 2 -
Hospital Insurance & Supplementary Medical Insurance
Rev. 124, 05-17-2019
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Chapter 3 -
Deductibles, Coinsurance Amounts, and Payment Limitations
Rev. 129, 11-22-2019
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Chapter 5 -
Definitions
Rev. 120, 11-02-2018
Medicare Benefit Policy Manual:
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Chapter 1 -
Inpatient Hospital Services Covered Under Part A
(Rev. 234, 03-10-2017)
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Chapter 2 -
Inpatient Psychiatric Hospital Services
(Rev. 253, 12-14-2018)
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Chapter 3 -
Duration of Covered Inpatient Services
(Rev. 261; Issued: 10-04-2019)
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Chapter 4 -
Inpatient Psychiatric Benefit Days Reduction and Lifetime Limitation
(Rev. 1, 10-01-2003)
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Chapter 5 -
Lifetime Reserve Days
(Rev. 257, 03-01-2019)
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Chapter 6 -
Hospital Services Covered Under Part B
(Rev. 267, 02-04-2020)
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Chapter 7 -
Home Health Services
(Rev. 265, 01-10-2020)
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Chapter 8 -
Coverage of Extended Care (SNF) Services Under Hospital Insurance
(Rev. 261; Issued: 10-04-2019)
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Chapter 9 -
Coverage of Hospice Services Under Hospital Insurance
(Rev. 246, 09-14-2018 )
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Chapter 10 -
Ambulance Services
(Rev. 243, 04-13-2018)
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Chapter 11 -
End Stage Renal Disease (ESRD)
(Rev. 257, 03-01-2019)
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Chapter 12 -
Comprehensive Outpatient Rehabilitation Facility (CORF) Coverage
(Rev. 255, 01-25-2019)
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Chapter 13 -
Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Services
(Rev. 263, 12-20-2019)
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Chapter 14 -
Medical Devices
(Rev. 198, 11- 06-2014)
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Chapter 15 -
Covered Medical and Other Health Services
(Rev. 259, 07-12-2019)
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Chapter 16 -
General Exclusions From Coverage
(Rev. 198, 11-06-2014)
Medicare Managed Care Manual:
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Chapter 1 -
General Provisions
(Rev. 125, 02-10-2017) )
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Chapter 2 -
Medicare Advantage Enrollment and Disenrollment
(Rev. 07-31-2018)
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Chapter 4 -
Benefits and Beneficiary Protections
(Rev. 121, Issued: 04-22-2016)
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Chapter 9 -
Employer/Union Sponsored Group Health Plans
(Rev. 111, 05-03-2013)
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Chapter 10 -
MA Organization Compliance with State Law and Preemption by Federal Law
(Rev. 103, 11-04-2011 )
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Chapter 11 -
Medicare Advantage Application Procedures and Contract Requirements
(Rev. 83, 04-25-2007)
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Chapter 14 -
Contract Determinations and Appeals
(Rev. 122, 05-27-2016)
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Chapter 16a -
Private Fee-for-Service (PFFS) Plans
(Rev. 99, Issued: 05-27-2011)
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Chapter 16b -
Special Needs Plans
(Rev. 123, Issued: 08-19-2016 )
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Chapter 17 (Subchapter D) -
Medicare Cost Plan Enrollment and Disenrollment Instructions
(Rev. 38, 10-31-2003)
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Chapter 17 (Subchapter F) -
Benefits and Beneficiary Protections
(Rev. 77, 10-28-2005)
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Chapter 21 -
Compliance Program Guidelines
(Rev. 110, 01-11-2013) Note: this is also listed as “Chapter 9 of the Prescription Drug Benefit Manual”
Medicare Prescription Drug Benefits Manual:
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Chapter 3 -
Eligibility, Enrollment and Disenrollment
(Rev. 07-31-2018)
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Chapter 4 -
Creditable Coverage Period Determination and the Late Enrollment Penalty
(In effect: 04-01-2010)
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Chapter 5 -
Benefits and Beneficiary Protections
(Rev. 14, 09-30-2011)
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Chapter 6 -
Part D Drugs and Formulary Requirements
(Rev. 18, 01-15-2016)
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Chapter 7 -
Medication Therapy Management and Quality Improvement Program
(Rev. 11, 02-19-2010)
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Chapter 9 -
Compliance Program Guidelines
(Rev. 16, 01-11-2013) Note: this is also listed as “Chapter 21 of the Managed Care Manual”
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Chapter 12 -
Employer/Union Sponsored Group Health Plans
(Rev.6, 11-07-2008)
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Chapter 13 -
Premium and Cost-Sharing Subsidies for Low-Income Individual
(Rev. 14, 10-01-2018)
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Chapter 14 -
Coordination of Benefits
(Rev. 17, 08-23-2013)
Medicare Marketing Manual:
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Medicare Marketing Guidelines
(Issued: 07/20/2017)
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Medicare Communications and Marketing Guidelines (MCMG)
(Issued: 10/05/2018)
Medicare Secondary Payer (MSP) Manual:
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Chapter 1 -
Background and Overview
(Rev. 125, 03-22-2019)
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Chapter 2 -
MSP Provisions
(Rev. 118, 04-28-2016)
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Chapter 3 -
MSP Provider, Physician, and Other Supplier Billing Requirements
(Rev. 125, 03-22-2019)
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Chapter 4 -
Coordination of Benefits Contractor (COBC) Requirements
(Rev. 125, 03-22-2019)
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Chapter 5 -
Contractor Prepayment Processing Requirements
(Rev. 125, 03-22-2019)
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Chapter 6 -
Medicare Secondary Payer (MSP) CWF Process
(Rev. 76, 11-19-2010)