Medicare

Medicare is our country’s health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare, too, including those who have disabilities and those who have permanent kidney failure or amyotrophic lateral sclerosis (Lou Gehrig’s disease). The program helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term care.

Medicare is financed by a portion of the payroll taxes paid by workers and their employers. It also is financed in part by monthly premiums deducted from Social Security checks.

The Centers for Medicare & Medicaid Services is the agency in charge of the Medicare program. But you apply for Medicare at Social Security, and the SSA can give you general information about the Medicare program.

Medicare has four parts

      * Hospital insurance (Part A) that helps pay for inpatient care in a hospital or skilled nursing facility
         (following a hospital stay), some home health care and hospice care.

      * Medical insurance (Part B) that helps pay for doctors’ services and many other medical services and
         supplies that are not covered by hospital insurance.

      * Medicare Advantage (Part C) plans are available in many areas. People with Medicare Parts A and B can
         choose to receive all of their health care services through one of these provider organizations under Part C.
     
      * Prescription drug coverage (Part D) that helps pay for medications doctors prescribe for treatment.

You may think that Medicaid and Medicare are the same. Actually, they are two different programs. Medicaid is a state-run program that provides hospital and medical coverage for people with low income and little or no resources. Each state has its own rules about who is eligible and what is covered under Medicaid. Some people qualify for both Medicare and Medicaid. For more information about the Medicaid program, contact your local medical assistance agency, social services or welfare office.

Who can get Medicare?

Hospital insurance (Part A)

Most people age 65 or older who are citizens or ­permanent residents of the United States are eligible for free Medicare hospital insurance (Part A). You are eligible at age 65 if:

      * You receive or are eligible to receive Social Security benefits; or
      * You receive or are eligible to receive railroad retirement benefits; or
      * You or your spouse (living or deceased, including divorced spouses) worked long enough in a government
         job where Medicare taxes were paid; or
      * You are the dependent parent of a fully insured deceased child.

If you do not meet these requirements, you may be able to get Medicare hospital insurance by paying
a monthly premium. Usually, you can sign up for this hospital insurance only during designated enrollment periods.

NOTE: Even though the full retirement age is no longer 65, you should sign up for Medicare three months before your 65th birthday.