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SEER-MHOS: Medicare Enrollment and Claims Data
Medicare is a federally funded program that provides health insurance for older adults ages 65 and older, persons with end-stage renal disease, and some individuals with disabilities. There are four components of Medicare coverage are described below:
- Part A coverage includes hospital, skilled-nursing facility, hospice and some home health care. Almost all Medicare beneficiaries have Part A coverage.
- Part B coverage covers physician and outpatient services. A majority of Part A beneficiaries elect to pay additional premiums for Part B coverage.
- Part C coverage refers to Medicare Advantage enrollment (e.g., enrollment in Managed Care or an HMO).
- Part D coverage, which provides prescription drug coverage for beneficiaries who purchase the benefit. Part D coverage began in 2006 and currently 60-70% of Medicare beneficiaries are enrolled.
Information about Medicare enrollment is available for all persons included in the SEER-MHOS data resource (both persons with and without a cancer diagnosis). Please note Medicare Part A and Part B claims are not reported during enrollment in Medicare Advantage.
Many Medicare Advantage enrollees have Medicare Part D prescription drug coverage. The SEER-MHOS database is now linked to SEER cancer, MBSF enrollment and Part D claims data. The Part D claims may now be requested as part of a SEER-MHOS Data Use Agreement (DUA) application. All projects requesting Part D data must:
- Provide adequate rationale to use Medicare Part D claims information,
- Be focused on a cancer-related research question; and
- Use MHOS (survey) data in their proposed project.
NCI conducted a feasibility study using Medicare Part D data linked to SEER-MHOS data, and the final technical report available upon request. Frequency tables of the Medicare Part D Prescription Drug Event File may be found on the SEER-Medicare: Medicare Claims Files webpage. SEER-MHOS Sample Size Estimator can report Part D coverage in SEER-MHOS.