Medicare

Medicare is a United States federal health insurance program established in 1965 under the Social Security Act. It provides coverage for people aged 65 and older, most younger people with disabilities, and people with End-Stage Renal Disease. The program is administered by the Centers for Medicare and Medicaid Services (CMS) and is funded through a combination of payroll taxes, beneficiary premiums, and general revenues.

Eligibility for Medicare generally depends on citizenship or lawful residence and work history. Most people qualify automatically for Part A if they or a spouse have paid Medicare taxes for a sufficient period (typically 10 years). Others qualify through disability status or certain medical conditions. People under 65 may become eligible if they receive Social Security disability benefits or have specific diseases; enrollment usually occurs during initial enrollment periods or special enrollment periods.

Medicare comprises several parts. Original Medicare includes Part A (hospital insurance) and Part B (medical insurance). Part A covers inpatient hospital care, skilled nursing facility care, hospice, and some home health services. Part B covers outpatient services, doctor visits, preventive services, and durable medical equipment. Beneficiaries can enroll in Part C, known as Medicare Advantage, private plans that bundle Part A and Part B and may include Part D drug coverage. Part D provides prescription drug coverage through private plans. Some beneficiaries purchase Medigap policies from private insurers to help cover gaps in Original Medicare.

Costs and limitations are an important consideration. Part A is often premium-free for those with sufficient work history but has deductibles and coinsurance. Part B, Part D, and Medigap plans charge premiums, and many plans have deductibles and copayments. Original Medicare generally does not cover most long-term care, dental, vision, or hearing services; supplemental coverage or Medicare Advantage plans are commonly used to obtain additional benefits.

Medicare remains a central component of U.S. health coverage, with plan options and costs varying by eligibility, location, and health needs.