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Official references
Medicare law & rules
Selected federal provisions that are especially useful when understanding coverage and plan rights. Each short excerpt links to the current official text.
Hospital insurance benefits
Part A law identifies major categories of hospital, skilled nursing, home health, and hospice benefits. Coverage conditions and benefit periods still apply.
Official excerpt (English)Read official source“inpatient hospital services, post-hospital extended care services, home health services, and hospice care”
Supplementary medical insurance
Part B is the medical-insurance side of Original Medicare. Detailed definitions, exclusions, medical necessity, and cost sharing determine what is payable.
Official excerpt (English)Read official source“medical and other health services”
Medicare Advantage eligibility and election
The statute ties Medicare Advantage eligibility to Part A entitlement and Part B enrollment, then sets election and enrollment rules.
Official excerpt (English)Read official source“entitled to benefits under part A and enrolled under part B”
Prescription drug plan enrollment
This section establishes how an eligible person may obtain Part D prescription drug coverage, including coordination with Medicare Advantage choices.
Official excerpt (English)Read official source“may obtain qualified prescription drug coverage through enrollment in a prescription drug plan”
Medicare Advantage disclosures
Medicare Advantage organizations must explain benefits, costs, networks, prior authorization, appeals, and other plan information in the CMS-prescribed manner.
Official excerpt (English)Read official source“Prior authorization rules and other review requirements that must be met in order to ensure payment for the services.”
Part D plan information
Part D sponsors must provide plan details including formulary operation, exception procedures, cost sharing, pharmacy access, and appeal rights.
Official excerpt (English)Read official source“the process for obtaining an exception to a plan’s formulary or tiered cost-sharing structure”