Medicare is the dominant health insurance plan that a health provider encounters when practicing medicine. Medicare is a Federal program established in 1965 to provide access to health insurance for the elderly and disabled. It is almost impossible, as a practicing health provider, to ignore the patient population covered by Medicare.

Physicians and certain outpatient health services are covered under Part B of Medicare. Even though Medicare is a national program, administration of Medicare Part B is accomplished by regional Contractors engaged by Medicare to administer the program on a state by state basis. Enrollment in Medicare by the regional contractor for one state does not immediately enroll you for another state (think independent licensure for each state).

Conversely, since all information for enrollment is maintained in the Medicare national database Provider Enrollment and Chain Ownership System (PECOS), termination for enrollment in one state may affect your enrollment for other states. Medicare provides for periodic revalidation of Medicare enrollment information in order to maintain uninterrupted participation.

As mentioned in the payer enrollment section, Medicare provides for an individual enrollment as well as an attachment (reassignment) to a group. If you do not maintain an individual Medicare enrollment for the state within you intend to practice you may go directly to the Medicare PECOS website and apply online by clicking here.

To save your Medicare enrollment information, register, log in and go to the Practice Preparations section behind our secure firewall.