What is Medicare, and how do you get it?

Unlike Medicaid, Medicare is largely based on age -- not income

Medicare is a federally run health insurance program that provides coverage to Americans who are 65 or older, regardless of income, medical history or health status.

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The government created the program in 1965, although it was broadened in 1972 to include certain people under the age of 65 who have a long-term disability. The program provides coverage to more than 60 million people in the U.S., according to the Kaiser Family Foundation.

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The program helps to pay for a slew of medical services, including hospitalizations, physician visits, prescription drugs, preventive services, skilled nursing facility and home health care, and hospice care.

Medicare is the second-largest program in the federal budget. In 2018, it cost $582 billion, or about 14 percent of total federal spending. In 2016, half of all people on Medicare had incomes below $26,200 per person and savings below $74,450, according to the KFF.

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There are four different types of Medicare coverage:

  • Part A: This covers inpatient hospital stays, hospital stays, care in skilled nursing facility, hospice care and some home health care. About 99 percent of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment.  The Medicare Part A inpatient hospital deductible that beneficiaries will pay when admitted to the hospital is $1,408 in 2020.  
  • Part B: This covers certain doctors' services, outpatient care, medical supplies and preventive services. For 2020, the Medicare Part B monthly premiums and the annual deductibles are $144.60 and $198, respectively.   WHAT IS MEDICAID, AND HOW DO YOU GET IT?
  • Part C: (Medicare Advantage): Through this plan, beneficiaries can enroll in a private health plan and receive all Medicare-covered Part A and Part B benefits. Most Medicare Advantage plans also offer prescription drug coverage.   
  • Part D: This covers outpatient prescription drugs through private plans that contract with Medicare, including stand-alone prescription drug plans. 

If you are turning 65, Medicare enrollment begins three months before your birthday and continues for seven months. If you are receiving Social Security benefits, you will be automatically enrolled in Medicare Parts A and B the month you turn 65. Otherwise, you will need to sign up for Part A and B - although some people may choose to delay signing up for Part B.

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When you get your Medicare coverage, you can choose whether or not to get a Medicare Advantage plan (Part C) or Medicare prescription drug coverage (Part D).

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