Main article: Medicare (United States)

Medicare (United States) is a national health insurance program in the United States, begun in 1966 under the Social Security Administration and now administered by the Centers for Medicare and Medicaid Services (CMS). It provides health insurance for Americans aged 65 and older, younger people with some disability status as determined by the Social Security Administration, as well as people with End Stage Renal Disease and Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's disease).

Overview

Medicare is divided into four parts: Part A, Part B, Part C, and Part D.

• Part A covers hospital care, skilled nursing facility care, nursing home care (as long as custodial care isn't the only care the patient needs), hospice, and home health services.
• Part B covers physician services, outpatient care, preventive services, and home health care. Part B also covers some services not covered by Part A, like some physical therapy and occupational therapy.
• Part C, also known as Medicare Advantage, is an alternative to Original Medicare (Part A and Part B) offered by private insurance companies approved by Medicare. It often includes additional benefits and may include prescription drug coverage (Part D).
• Part D covers prescription drugs through private plans that contract with Medicare.

Eligibility

To be eligible for Medicare, an individual must be either a U.S. citizen or a permanent legal resident for at least five continuous years, and one of the following:

• 65 years or older
• Under 65 with certain disabilities
• Any age with End Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant) or ALS.

Funding

Medicare is funded primarily through a combination of a payroll tax, beneficiary premiums, and surtaxes from beneficiaries, co-pays and deductibles, and general U.S. Treasury revenue.

Challenges and Reforms

Medicare faces financial challenges as the American population ages and healthcare costs rise. Reforms have been proposed and implemented over the years to try to ensure the sustainability of the program. These include adjustments to the way providers are paid, efforts to reduce fraud and waste, and the introduction of Medicare Advantage and Part D.

Impact

Medicare has had a profound impact on the health and financial security of millions of American seniors and disabled individuals. It has helped to reduce poverty among seniors and has improved access to healthcare for its beneficiaries.

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