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Glossary > Medicare (federally funded health insurance program )

Medicare (federally funded health insurance program )

What Is Medicare?

Medicare is a federally funded health insurance program designed for those who are 65 years old or older.  While you automatically become eligible for Medicare once you turn 65 years old, there are exceptions for people younger than 65, which include those with certain disabilities and those with End Stage Renal Disease.

 

When Was Medicare Put Into Effect?

President Lyndon B. Johnson signed the Social Security Act Amendments in 1965, which is more commonly referred to as Medicare.  This bill was widely debated within the government for at least 2 decades prior to being signed, after President Harry S. Truman asked Congress to implement a national health insurance plan.

 

Who Pays for Medicare?

Medicare is paid for through Social Security, which is a federal system that provides assistance to those who need it. Most people will see a deduction of 1.45% of their paycheck that goes toward Medicare. It may be indicated differently depending on where you live, and it is matched in full by your employer. Those who are self-employed pay the full amount. 

 

Parts of Medicare

 

Original Medicare  

Medicare Part A 

This covers hospital service, hospice care and even home healthcare in some instances. Any inpatient care in a facility is usually covered. 

 

Medicare Part B 

This is the most common form. It covers all typical medical procedures like regular doctor checkups and other preventative care. Part B is mostly responsible for covering outpatient services. 

 

Medicare Advantage (Medicare Part C) 

This also referred to as the Medicare Advantage plan. It acts as a partnership between the Medicare system and a private company. The company works with the Medicare system to get people all the benefits from both Part A and Part B. Usually, HMOs and PPOs fall under the umbrella of Part C coverage. 

 

Medicare Part D 

This is the part that covers prescription drugs and other medicines.  This plan can either be purchased on it’s own, what is known as a stand alone plan, or it can be part of a Medicare Part C plan that offers a drug plan as well.

 

Medicare Supplemental Plans

Medicare Supplemental Plans, also known as Medigap plans, are plans that are still approved by at the federal level, but are run and purchased through private health insurance companies.  These plans are designed to fill in any costs that would not be covered under Original Medicare.

 

Who Is Eligible for Medicare?

The program is mostly designed to help cover the elderly and retired individuals who are no longer covered through their employer's healthcare program as a means to keep them covered for life. In order to be eligible, you must be a citizen of the United States or have lived there for at least five years. 

 

Other Eligibility Factors

There are other individuals besides the elderly who are eligible for Medicare coverage. Those under the age of 65 who are disabled permanently are eligible as long as they have been receiving benefits for disability for at least two years. If you have either had a kidney transplant or are in the late stages of renal failure and are under the age of 65, you are also eligible. The service is also available to those who have ALS.

 

If you are curious to find out if you are eligible for Medicare, you can visit www.healthcare.gov, or give our experienced agents a call at 858-284-1685, or simply enter your zip code here!