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gigs
11-06-2006, 09:34 PM
What is Medicare?[/URL]

Established in 1965, Medicare is a federal health insurance program that provides health care coverage for individuals age 65 and older. The program also covers certain persons under age 65 with disabilities.
Authorized under Title XVIII of the Social Security Act, Medicare consists of Hospital Insurance (Part A) and Supplementary Medical Insurance (Part B). Part C refers to the Medicare Advantage program (formerly known as Medicare+Choice), under which private plans provide Medicare benefits to enrollees. A voluntary outpatient prescription drug benefit (Part D) authorized by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA)1 (http://www.urch.com/forums/) will be implemented in 2006.2 (http://www.aarp.org/research/medicare/coverage/the_medicare_program_a_brief_overview.html#footnot e2)
Whom Does Medicare Cover?

Medicare eligibility is available to individuals who fall into three specified categories defined by either age, disability, or end-stage renal disease. The majority of individuals are eligible for Medicare by virtue of attaining age 65.
In 2003,[URL="http://www.aarp.org/research/medicare/coverage/the_medicare_program_a_brief_overview.html#footnot e3"]3 (http://www.urch.com/forums/) Medicare provided coverage to:

35 million persons age 65 and older—At age 65, individuals qualify for Medicare if they or their spouses paid Social Security taxes for at least 40 calendar quarters (10 years) or if they qualify for Railroad Retirement benefits.4 (http://www.aarp.org/research/medicare/coverage/the_medicare_program_a_brief_overview.html#footnot e4)
6 million persons under age 65 with disabilities—Those under age 65 who have received Social Security Disability Insurance (SSDI) cash benefits for at least 24 months are eligible for Medicare.5 (http://www.aarp.org/research/medicare/coverage/the_medicare_program_a_brief_overview.html#footnot e5)
Almost 100,000 persons under age 65 with end-stage renal disease (ESRD)—Those with ESRD under age 65 are eligible for Medicare if they or their spouses paid Social Security taxes for at least 40 quarters.Part A covers:

Inpatient hospital services up to 90 days per “spell of illness”6 (http://www.aarp.org/research/medicare/coverage/the_medicare_program_a_brief_overview.html#footnot e6)
Skilled nursing facility services for up to 100 days per spell of illness following a 3+ day hospital stay
Home health care up to 100 visits per spell of illness following a 3+ day hospital stay
Hospice care
Inpatient psychiatric care, for up to 190 days during a beneficiary’s lifetime
Blood (after the beneficiary pays for the first 3 pints per year)Part B covers:

Physicians’ services, including office visits and a one-time physical examination for new beneficiaries7 (http://www.aarp.org/research/medicare/coverage/the_medicare_program_a_brief_overview.html#footnot e7)
Durable medical equipment (e.g., wheelchairs, oxygen) and supplies
Outpatient hospital services
Outpatient mental health services
Clinical laboratory (e.g., blood tests, some screening tests, etc.) and diagnostic tests
Outpatient occupational, physical, and speech therapy
Home health care not preceded by a hospital stay and visits over the 100-day Part A limit
Some preventive services (e.g., mammograms, diabetes screening)8 (http://www.aarp.org/research/medicare/coverage/the_medicare_program_a_brief_overview.html#footnot e8)
Blood (after the beneficiary pays for the first 3 pints per year)