What is Medicare?

A look at Original Medicare, its options for private coverage, and who can get them.

How Medicare got started and grew

Medicare is a federal health insurance program for people who are 65 years old or older. It was started in 1965.

In 1972, the program, which is run by the Centers for Medicare and Medicaid Services, was made bigger to include people younger than 65 who have permanent disabilities, such as end-stage renal disease (ESRD). In 2001, Congress added amyotrophic lateral sclerosis (ALS) to the list of diseases that qualify a person for Medicare before age 65. About 14 percent of the people on Medicare, or almost 9 million people, are younger than 65.

How many people in the US have Medicare?

Medicare covers almost 64 million people in the U.S. right now, and in 2020, it cost more than 4% of the U.S. gross domestic product to pay for. In that year, the total amount spent on Medicare was about $917 billion. In 2031, it is expected to reach $1.78 trillion.

How does Medicare get paid for?

Funding for each part of Medicare is different (see Figure 7 in this resource).

Most of the money for Part A comes from payroll taxes, which go to the Hospital Insurance Trust Fund.

Part B is paid for by general tax money and the premiums that Medicare recipients pay.

Part C, which is called "Medicare Advantage," is also paid for by general tax money and premiums from beneficiaries.

Part D's coverage for prescription drugs is paid for by general revenue, premiums, and payments from the states.

Who can receive Medicare?

In general, you can get Medicare if one of the following things is true:

You are 65 years old and have lived in the US legally for at least five years straight.

you are under 65 and have amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, or end-stage renal disease (ERSD), or you are under 65 and have been getting Social Security Disability benefits for at least 24 months.

You must also have paid into the Medicare system in order to get Medicare Part A for free. This means that you, your spouse, or a parent, if you are signing up as a disabled child, must have worked for at least ten years before signing up for Medicare. If not, you can still get Medicare Part A, but you will have to pay a fee.

How do people in the United States get Medicare coverage?

There are four main parts that make up Medicare:

1. Medicare Part A, which is often called "hospital insurance," is for inpatient care. It pays for stays in hospitals, skilled nursing facilities, home health care, and hospice care, as long as they meet certain criteria.
2. Medicare Part B, which is often called "medical insurance," pays for outpatient costs like doctor and nurse fees, x-rays, diagnostic tests, and renal dialysis, as well as some equipment and a range of services. Part B also pays for hospital stays if the patient is kept under observation instead of being admitted as an inpatient.
3. Medicare Advantage (Part C) is a program that lets Medicare recipients get benefits covered by Medicare through private health plans. These plans may also offer extra benefits, such as coverage for prescription drugs (ie, integrated Part D coverage). In exchange for the benefits, coverage is usually limited to a network of doctors and hospitals (as opposed to the nationwide access to providers that Original Medicare beneficiaries have).
4. Medicare Part D, which covers prescription drugs, gives more than 49 million Americans who sign up for Part D plans made and run by private health insurance companies price breaks on their prescription drugs (more than 24 million people have stand-alone Part D plans, and about 25 million have Part D coverage integrated with a Medicare Advantage plan).
5. Medicare supplement, or Medigap, is extra coverage that people with Original Medicare can buy to pay for out-of-pocket costs for Medicare-covered services that they would have to pay for themselves otherwise. Most states offer ten standard plans, A through N, with different combinations of money-saving benefits. (Note that plans C and F, which both cover the Part B deductible in full, are not available to people who become eligible for Medicare after 2019.) Plan G, which is the same as Plan F except that it covers the Part B deductible, is now the most complete Medigap plan for people who just became eligible.

I do not offer every plan available in all areas, if you would like to see all your options, go to 800- medicare or Medicare. Government.

I offer plans from 8 companies and all the plans they have.