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Medicare

INTRODUCTION

Medicare is a United States publicly funded federal health insurance plan for the elderly and disabled that covers about 45 million Americans. People contribute to Medicare by payroll taxes paid during their years of employment. These funds are held in the Hospital Insurance Trust fund and are administered by the Centers for Medicare and Medicaid Services (CMS).

The following groups are eligible for Medicare benefits:

  • Almost all individuals older than 65 years of age (excluded are those who have not contributed to the Medicare program during their working years)
  • Those younger than 65 who are receiving social security disability payments
  • People requiring dialysis regardless of their age via the end-stage renal disease (ESRD) program

Medicare consists of four parts (A,B,C,D): Part A primarily pays for inpatient services; Part B covers outpatient services; Part C ("Medicare + Choice", renamed "Medicare Advantage" in 2006), and Part D, a pharmacy benefit.

BASIC COVERAGE

Part A (the hospital insurance program) — Almost all people receiving social security benefits are eligible for Part A coverage through Medicare. There is no enrollment fee for most recipients because they or their spouses have 40 or more quarters of Medicare-covered employment. However, those with 30 to 39 quarters of coverage pay a monthly premium of $248, and those with less than 30 quarters may obtain Part A coverage by paying a monthly premium of up to $451 in 2012 [1].

                  

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Literature review current through: May 2013. | This topic last updated: Jun 6, 2012.
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References
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