SEER-CAHPS: Medicare Enrollment & Claims Data

Medicare is the federally funded program that provides health insurance for the elderly, persons with end-stage renal disease, and some disabled individuals. For persons age 65 and over, 97 percent are eligible for Medicare. Almost all Medicare beneficiaries have Part A coverage that includes hospital, skilled-nursing facility, hospice and some home health care. 96 percent of elderly Part A beneficiaries choose to pay a monthly premium to enroll in Part B of Medicare that covers physician and outpatient services. Medicare Part C refers to HMO enrollment. While some Medicare beneficiaries are enrolled in HMOs, most have fee-for-service (FFS) coverage. In 2006, Medicare initiated Part D, which provides prescription drug coverage for beneficiaries who purchase the benefit.

Information about Medicare eligibility and enrollment is available for all persons included in the SEER-CAHPS data (both cancer and non-cancer cases). Medicare claims (bills) are available only for persons with FFS coverage. For more information about Medicare data, please see the Research Data Assistance Center Web site.

Below you will find information about the specific Medicare claims and enrollment data files included in SEER-CAHPS:

• Summarized Denominator (SUMDENOM) File
  • Information about non-SEER cases
• Medicare Claims Files
  • Information about Medicare claims data files
• SEER-CAHPS: HCPCS Tables
  • Provides an estimate of the utilization of specific medical services or prescription drugs over time according to NCH and Outpatient claims