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Medicare Program Overview

Medicare is a health insurance program for:

  • people age 65 or older,
  • people under age 65 with certain disabilities, and
  • people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).

Medicare consists of the following:

Part A Hospital Insurance
Most people don't pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working.
Medicare Part A (Hospital Insurance) helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits.

Part B Medical Insurance
Most people pay a monthly premium for Part B. Medicare Part B (Medical Insurance) helps cover doctors' services and outpatient care. It also covers some other medical services that Part A doesn't cover, such as some services provided by

  • physical and occupational therapists and
  • some home health care.

Part B helps pay for these covered services and supplies when they are medically necessary.

Prescription Drug Coverage
Most people will pay a monthly premium for this coverage. Starting January 1, 2006, new Medicare prescription drug coverage became available to everyone with Medicare. Everyone with Medicare receives this coverage that may help lower prescription drug costs.

Medicare Prescription Drug Coverage is insurance provided private companies. Beneficiaries choose the drug plan and pay a monthly premium. Like other insurance, if a beneficiary decides not to enroll in a drug plan when they are first eligible, they may pay a penalty if they choose to join later.

For more information visit www.medicare.gov

Note: Information for this article provided by www.cms.gov