What Is Medicare?
What is Medicare?
Medicare is a federal health insurance program that helps pay for covered healthcare services for eligible individuals. Created in 1965 under Title XVIII of the Social Security Act, Medicare was initially designed for people aged 65 and older but has since expanded to cover younger individuals with permanent disabilities.
Medicare is divided into four parts:
⦁ Part A (Hospital Insurance)
⦁ Part B (Medical Insurance)
⦁ Part C (Medicare Advantage Plans)
⦁ Part D (Prescription Drug Coverage)
It covers a wide range of services, including hospital stays, physician visits, prescription medications, skilled nursing facility care, home healthcare, and hospice services.
In general, individuals are eligible for Medicare if they or their spouse have worked at least 40 quarters in employment covered by Medicare taxes, are 65 years old or older, and are U.S. citizens or permanent residents.
Medicare also provides coverage to younger individuals who cannot work due to a severe medical condition expected to last at least one year or result in death, or those diagnosed with End-Stage Renal Disease (ESRD) requiring dialysis or a transplant.
The program is administered by the Centers for Medicare & Medicaid Services (CMS), part of the U.S. Department of Health and Human Services (HHS), with support from private contractors handling claims, audits, and quality oversight.
Medicare is not free. It's important to understand the costs involved so you can plan your budget and choose the coverage that best fits your needs. Key expenses include:
⦁ Monthly Premiums: Regular payments required for certain parts of Medicare (like Part B and Part D).
⦁ Yearly Deductibles: The amount you pay out of pocket each year before Medicare begins covering services.
⦁ Copayments and Coinsurance: Your share of costs for services after meeting your deductible.
⦁ Prescription Drug Costs: Expenses for medications under Medicare Part D.
⦁ Potential Late Enrollment Penalties: Extra costs if you delay enrolling when you're first eligible.
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