Program Purpose:
Medicare (Web site), created in 1965 as an amendment to the Social
Security program, provides health insurance to persons age 65 and older, to qualifying
persons under 65 with disabilities, and to persons of any age suffering from
permanent kidney failure. Medicare should be considered as offering payment for
the "basic" costs of health care. Not all medical expenses or the
costs of long-term-care are covered. Medicare is the nation's largest health
insurance program, currently covering over 39 million people.
Medicare or Medicaid?
These two programs are often confused. Medicaid is administered by state
governments to assist persons with little or no income. The U.S. federal
government helps support state Medicaid programs, but each state sets its own eligibility
requirements and coverage details. Some persons may qualify for both federal
Medicare and state Medicaid.
Medicare Eligibility:
U.S. citizens and non-citizens of lawful alien status may receive Medicare
benefits. The following groups are currently entitled to Medicare benefits:
- Any person age 65 or older
- Any person, regardless of age, who has been entitled to Social Security or Railroad Retirement disability benefits for at
least 24 months
- Any person, regardless of age, requiring continuing dialysis or kidney
transplants
- Other elderly persons not covered by traditional health insurance who
choose to buy into the Medicare program
[Complete
eligibility details from the Centers
for Medicare & Medicaid Services]
What Medicare Provides:
In its most simple form, Medicare provides two benefits - Hospital Insurance
and Medical Insurance. Very brief descriptions of both are given here and you
need to be aware that Medicare in an extremely complex program, with several
options and costs depending on several factors. Persons with any questions about
Medicare should be sure to call, toll-free, 1-800-MEDICARE
(1-800-633-4227) to speak to a Medicare representative. People who are deaf or hard of hearing may call their
toll-free TTY number, 1-800-325-0778.
- Hospital Insurance (Medicare Part A): Part A generally covers
inpatient hospital care, care in critical access hospitals, skilled nursing
facilities, hospice care, and some home health care. Most people get Part A
automatically when they turn 65 and are not required to pay a monthly
premium.
- Medical Insurance (Medicare Part B): Part B generally pays for
doctors' fees and services, outpatient hospital care, and some medical costs
not covered by Part A, like physical and occupational therapy. Part B will
helps pay for some covered services only when they are declared medically
necessary. Medicare Part B is not free. The current (2003) cost of Part B is
$58.70 per month, but can be higher in some cases. Enrollment in Part B is
completely optional. You can sign up for Part B anytime during a 7 month
period that begins 3 months before you turn 65. Visit your
local Social Security office, or call the Social Security Administration
at 1-800-772-1213 to sign up.
Questions? Call 1-800-MEDICARE
(1-800-633-4227) TTY number, 1-800-325-0778.
Also see: Your
Medicare Benefits - Parts A and B (.pdf document - requires Adobe
Acrobat Reader)
Enrolling in Medicare:
If you are already getting Social Security retirement or disability benefits,
or Railroad Retirement checks, you should be contacted by Social Security
shortly before you become eligible for Medicare. If not, contact your nearest Social Security office three months
before your 65th birthday to sign up.
Other Medicare Features and Links:
For more online Medicare information see: the Health
Care Financing Administration site the Medicare
site, and Social Security Online.
Important Medicare News:
About Medicare-approved Drug
Discount Cards
As early as May 2004, almost anyone with Medicare will be eligible to enroll
in the new Medicare-approved drug discount card program. The discount cards will
be good until at least December 31, 2005.
Details of Medicare
Prescription Drug Plan
This article presents the most current information regarding the Medicare
Prescription Drug Improvement and Modernization Act of 2003 that you will need
to help you make the best decisions regarding your Medicare coverage.
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