In 1965 the United States passed their senior citizen medical insurance entitled “Medicare”. It was a medical aid insurance for any citizen when they reached the age of 65. It was intended to not discriminate against people depending on wealth or any other factor. While this was a good start, Medicare has had to undergo many updates through the years as medical technology and knowledge has increased. Before the introduction of Medicare, about 40% of qualified senior citizens were unable to afford health insurance.
In order to qualify for Medicare you have to hit the following requirements:
- Be over 65 in the United States.
- Be a United States Citizen or have been a permanent resident for 5+ straight years.
- Have paid into Medicare taxes for 10 years.
- Be under 65 in the United States
- Have a qualifying disability (There are many qualifying disabilities)
- Receiving appropriate financial benefits for said disability
Medicare is broken is up into 4 distinct sections. As Medicare was evolved the additional sections were included. It’s important to note that Medicare does not cover all costs. As it is a form of insurance, there is often co-payments, deductibles and some things just not covered. It’s intended to reduce the burden of medical costs, but not alleviate them completely.
Part A: Hospital and Hospice Insurance
Part A is built off the original Medicare introduction. Part A covers stays in hospitals. But it’s important to note that it only covers the first 60 days in hospital at cost. After that patients will have to pay a deductible and then pay a daily fee as well. It may seem that a way around this is to simply be taken out of the hospital and then readmitted soon after. Because of this potential for abuse, the Medicare program will remove payments and fine hospitals if it finds they are readmitting too many of their patients.
Part B: General Medical Insurance
Part B of Medicare is technically optional, though there’s some penalties for not enrolling unless you are working and getting health insurance from your employer. Part B has a maximum deductible value, and after that point, Medicare will cover 80% of the expenses incurred by the enrollee. This once again shows the Medicare program is not a sop to all expenses, but does help alleviate the financial problems. Part B of the program is intended for doctor's visits, x-rays, vaccinations, chemotherapy, etc. It tries to include all non-hospital based medical expenses. One way to look at it is that Part A is for non-scheduled and serious issues, while Part B is for scheduled issues (whether they be serious or non life-threatening). There is a monthly fee for enrollment in Part B of Medicare.
Part C: Medicare Advantage Plans
Part C of Medicare is an additional addendum. It is for enrollee’s of Parts A and B. They can receive a spending limit on their out of pocket expenses therefore protecting them from severe expenses. You must have a primary care physician in order to be eligible for part C of Medicare. Part C is usually covered by participation in a Health Maintenance Organization (HMO) .
Part D: Prescription Drug Plans
George W. Bush helped created Part D as part of his election platform. This addendum helps reduce the cost of prescription drugs so long as the Medicare enrollee joins a Prescription Drug Plan.