The Medicare health program is the government health care plan that is available to seniors over the age of 65, people under 65 years old with certain disabilities and those who have end-stage renal disease that requires dialysis or a kidney transplant. The healthcare program consists of three levels of coverage, Part A, Part B and Part D, or prescription drug coverage.
History
President Lyndon Johnson first signed the Medicare health program into law in 1965, reports the U.S. Department of Health and Human Services. In 1972, disabled people and those with end-stage renal failure became eligible for Medicare. Over the years, additional benefits such as hospice care and physical rehabilitation were added. The Medicare Modernization Act (MMA), which added an outpatient prescription drug benefit to the Medicare health program, was put into law during the administration of George W. Bush in 2003.
Benefits
Medicare Part A provides hospitalization coverage that is free to most eligible recipients. Payroll taxes paid while working, or those paid by a spouse, have paid for the premiums of this coverage. In-patient care at a hospital and some home health care are covered in addition to critical care and skilled nursing facilities. Hospice assistance is covered by Medicare Part A. Medicare Part B helps to pay doctors' services and outpatient care. Also called medical insurance, Part B Medicare coverage also pays for a number of services not covered by Part A, including physical and occupational therapy and home health care when it is medically necessary.
Costs
A premium, which average about $78 per month, is required for Medicare Part B coverage. Medicare Advantage is an option available to those eligible for Medicare coverage and requires additional premiums. Medicare Advantage offers added benefits such as wellness coverage, preventative medicine and prescription drugs. Medigap is a health insurance policy that is sold by private insurance companies to pay any bills not covered by Medicare. Payments from Medigap policies cover services such as deductibles and coinsurance requirements for Part A and Part B, foreign travel emergency treatment, excess charges and other things not covered by Medicare.
Considerations
Private companies are under contract to provide the insurance that helps defray the costs of prescriptions and protect against increased future costs through Medicare Part D plans. Medicare beneficiaries must enroll in a prescription drug plan at the time of enrollment or face a possible penalty fee. Advantage plans are offered through health maintenance organizations (HMO), preferred provider organizations (PPO), private fee-for-service plans and plans for special needs. There are 12 standardized plans that are approved by the federal government that can be sold as Medigap policies.
Assistance
Most people receive a notification from Medicare when they become eligible. Medicare Part A is an automatic benefit for retired and eligible Americans. Options for other coverage such as Part B and prescriptions drug coverage are offered during enrollment periods. Special assistance is available to help participants make educated choices and understand their benefits through organizations such as AARP or at the official government site for Medicare.
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