Medicare

Medicare was established in 1965 through the Social Security Administration. It is the national health insurance for people over the age of 65, people under the age of 65 with disabilities, and for people in an end-stage renal disease, such as kidney failure. Medicare covers over 40 million people.

In 2003, President Bush signed the Medicare Modernization Act, which added an outpatient drug benefit.

What Medicare Covers

There are two versions of Medicare: Part A and Part B. Medicare Part A is free to anyone eligible for Social Security retirement or disability benefits. Those who are not eligible for Medicare Part A -- in other words, people who are not eligible for Social Security retirement -- must pay a premium if they wish to receive Medicare. How much they pay is determined by how many qualified Social Security quarters are earned. The cost per month ranges between $205 and $375.

Everyone who receives Medicare Part B must pay for it. The premium is $78 per month.

Medicare Part A covers inpatient hospital care, nursing home care, home health care, and hospice care. The inpatient hospital care covers the first 90 days in a benefit period, but there are deductibles and co-payments. Co-payments can be over $200 per day during part of the hospital stay. Medicare provides up to 100 days in a skilled nursing facility, after a 3-day hospital stay, the first 20 days of which are at no charge. After that, there is a co-pay of over $100 per day up to day 100. Home health care visits are covered if the patient is unable to leave the house for health care, if the care is provided by a skilled nursing professional, if the home nursing company is certified by Medicare, and if the doctor has prepared a plan of care. Hospice care is paid for if the doctor verifies that the patient has a terminal illness with less than six months to live. If hospice care is chosen, other hospital-care Medicare benefits are waived.

Medicare Part B covers medical expenses such as physician care, ambulance service, medical equipment, outpatient services, mental health services, and rehabilitation therapy.

Using Medicare

Patients with Medicare should always use a certified Medicare provider in order to receive full benefits available. Present the Medicare card when receiving services. Medicare providers will submit all paperwork on the patient’s behalf.