Medicare Coverage

Medicare History

Medicare is a national form of health insurance that is funded by the federal government, in part through the payroll taxes and minimal monthly premiums. It was created in 1966 as a result of the Social Security Act, and it is meant to address the medical needs of U.S. citizens age 65 and older. It also covers certain disabled citizens who are under the age of 65 and people suffering from End-Stage Renal Disease, which is permanent kidney failure treated with dialysis or a transplant.

In 1977, the program was transferred from administration by the Social Security Administration to the Health Care Financing Administration (HCFA), which is now responsible for establishing and enforcing the regulation for the program. HCFA is responsible for auditing the records of health care providers who have received program dollars to ensure they are both billing for the appropriate amount and are providing adequate levels of care to Medicare patients.

Medicare is available to all elderly citizens, regardless of their financial need. This means the very wealthy and the impoverished qualify for the same benefits, and these benefits are consistent across the nation, no matter where you receive medical care.

Medicare Coverage

The basic coverage this plan has to offer is commonly divided into four parts.

Part A

Medicare Part A provides for hospitalization. This includes the actual hospital stay and aftercare, such as necessary nursing care, home health care, and hospice care. This part of the program is available without charge to anyone who has paid Medicare taxes through payroll deduction or whose spouse has paid this tax for at least 40 quarters. For those who do not meet these qualifications, a moderate monthly premium applies.

Part B

Medicare Part B provides of doctor visits, laboratory testing, and certain outpatient services, such as:

• Medical equipment
• Medical supplies
• Home health care
• Physical therapy

While Part A is provided at no additional cost to most individuals, Part B provides optional coverage at a minimal monthly premium, which is periodically adjusted, but is still a more affordable means of ensuring you can afford health care when you need it than another other policy on the market.

Part C

Part C is compromised of the Medicare Advantage plans. These plans allow individuals to receive program benefits through private health insurance plans.

Part D

Since neither Part A or Part B provides for prescription drug coverage, HCFA regulation to provide for Medicare Part D, a prescription drug plan that is regulated by the program but is actually administered by private health care insurance companies.

How to Apply

To apply for Medicare, visit for your local Social Security office, call 1-800-772-1213, or apply online at www.socialsecurity.gov. Be prepared to answer a series of questions, including such information as:

• Birth Date
• Social Security number
• Address

It is best to apply about three months prior to your 65th birthday, to ensure that your application has time to process, and you do not experience a lapse in coverage.

In Conclusion

While there has been some concern that the financing for this government backed insurance program may not be sufficient to meet the long term needs of the U.S. populations, it is still one of the better options for senior citizens who many find they cannot afford the exorbitant cost of private insurance coverage, or worse yet, have so many health problems that they can no longer get coverage.