Centers for Medicaid and Medicare Services

Programs Centers for Medicaid and Medicare Services

Providing efficient healthcare to its citizens should be one of the top priorities for any country.

The Centers for Medicare and Medicaid Services (CMS) is the agency under the U.S. Department of Health and Human Services responsible for managing the country’s major healthcare programs.

The CMS administers federal healthcare programs such as Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP), working in partnership with state governments to ensure that these services effectively meet local needs.

Importance of Centers for Medicaid and Medicare Services

Importance of Centers for Medicaid and Medicare Services

CMS is responsible for collecting and analyzing data, producing research reports and eliminating instances of fraud and abuse within the U.S. healthcare system.

This federal agency aims to offer a healthcare system with excellent care, access and affordable health coverage.

Why is the Centers for Medicare and Medicaid Services (CMS) important

The Centers for Medicare and Medicaid Services (CMS) is a major U.S. Department of Health and Human Services agency. It is headquartered in Baltimore, Maryland and works with every state government to administer basic health services and insurance programs.

The CMS programs serve over 100 million Americans, encompassing a wide range of demographics, including the elderly, low-income families, pregnant women, and individuals with disabilities.

The beneficiaries of the CMS programs include infants, pregnant women, elderly citizens, low-income populations, and people with significant disabilities.

Major Programs under the Centers for Medicare and Medicaid Services (CMS)

Now that you know what exactly CMS is, let’s take a detailed look at some of the major healthcare programs run through the agency and how they can benefit you:

1 – Medicaid

Medicaid is a joint federal and state program that provides health coverage to people with low income. Each state operates its own Medicaid program within federal guidelines. The Center for Medicaid & CHIP Services (CMCS) within CMS oversees Medicaid and the Children’s Health Insurance Program (CHIP).

Essentially, Medicaid consists of over 50 specific programs. Every US state or territory creates specific rules for its citizens and works under the supervision of CMS.

CMCS (Center for Medicaid and CHIP Services) is a low-income program CMS offers.

Under this, federal funds are combined with state-sponsored funds to pay benefits for low-income citizens. Regular medication is vital to lowering long-term medication costs.

CMS is focused on promoting prevention and early detection tools to lower healthcare costs and promote wellness and good health.

2 – Affordable Care Act

“The Affordable Care Act (ACA) expanded Medicaid eligibility and funding, improved benefits in the Children’s Health Insurance Program (CHIP), including dental care, and established new health insurance marketplaces with premium subsidies for many Americans. It also required most Americans to have health insurance, a mandate later zeroed out at the federal level in 2019.

It also includes early diagnostics, screening and detection, and inoculation services. This initiative is an excellent solution for those between Medicaid and Obamacare insurance segments.

CMS can develop and initiate the additions to the Basic Health Plan in the new Affordable Care Act.

These programs are available for state residents who are ineligible for insurance coverage under the CHIP or Medicaid programs.

Under the Affordable Care Act, Medicaid expansion allows coverage of individuals with incomes up to 138% of the federal poverty level in participating states. The Basic Health Program, an option for states, can provide coverage for individuals with incomes up to 200% of the federal poverty level who would otherwise be eligible to purchase coverage through the Health Insurance Marketplace. A Basic Health Plan offers at least 10 essential benefits and exceeds the minimum economic value.

3 – Children’s Health Insurance Program (CHIP)

The Children’s Health Insurance Program (CHIP) was launched in 1998 and was formed as part of a national health insurance law.

Under this, the CMS matches the fund amount offered by the state government with federal funds to provide affordable health coverage for children from low-income households.

This is incredibly useful if your household’s income is too high for Medicaid but too low for private insurance coverage.

CHIP eligibility varies by state, but it typically covers children in families with incomes too high to qualify for Medicaid but too low to afford private insurance. While many states have expanded CHIP eligibility to at least 200% of the federal poverty level, specific eligibility criteria can vary. This ensures that CHIP is accessible to the largest possible number of beneficiaries.

4 – Medicare

CMS is responsible for supervising the Medicare program, too. Medicare is a federal program providing health insurance primarily to individuals aged 65 and older and younger people with certain disabilities and conditions like End-Stage Renal Disease (ESRD).

This program supports public and private health insurance coverage with equal ease.

Some of the major Medicare programs that provide health insurance for elderly and disabled Americans include:

  • Original Medicare, including Medicare Part A and Medicare Part B and is comprehensive health insurance that meets the Individual Mandate.
  • Medicare Advantage – Part C
  • Prescription Drugs – Part D


The Centers for Medicaid and Medicare Services are incredibly important avenues for receiving optimal health insurance coverage, mainly if you belong to the low-income household category or are classified as an elderly or disabled US citizen.

It is highly advised to contact the CMS in your state or territory to learn the specific benefits that you are eligible to receive under CMS within your state.

See Also

How to Get Medicare to Pay for Dental Implants

Does Medicaid Cover Dermatology

How to Register for NRMP?

Grants for Women Starting a Business

Current Version
March 6, 2024
Updated By
Andrea Morales G.
July 6, 2018
Written By
Shubham Grover

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