Colorful names like Trailblazer, Palmetto, and National Heritage might put you more in mind of your local race track than your local Medicare carrier; but the Centers for Medicare and Medicaid Services (CMS) is betting that these insurance and government benefit administrator companies are the best ones to handle your claims if you are a Medicare fee for service patient. Medicare is the Federal Governments health insurance program. In general, you are entitled to Medicare coverage if you or your spouse paid enough federal income tax to qualify for Social Security benefits. It becomes available when you turn 65, if you have a disability such as renal failure (needing dialysis) or Lou Gehrigs disease (Amyotrophic Lateral Sclerosis), or if you qualify for and wish to receive hospice services. However, the Federal Government does not actually process your claim. This job is done by private companies that have been awarded Medicare Administrator Contracts. They are insurance companies, such as National Heritage Insurance Corporation, or government benefit administrator companies, such as Palmetto GBA. Currently, there are about eleven local Medicare administrator companies across the United States. In the past, a single state may have had several local Medicare carriers, or one company may have been servicing Part A claims in some states, and Part B claims in others. But thanks to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, each local Medicare administrator now generally covers several contiguous states for both Part A and Part B. Four companies cover all of the claims for home health care and hospice; four others (with some overlap) cover claims relating to durable medical equipment (such as hospital beds, wheelchairs, or oxygen concentrators).
