Medicare

Medicare is a federal health insurance program established in 1965 and covers individuals aged 65 and older, some disabled individuals under the age of 65, and patients with end-stage renal (kidney) disease.

Medicare coverage is tied to eligibility for Social Security or Railroad Retirement benefits. In 2015, there were almost 56 million people enrolled nationwide.

The program includes:

Hospital Insurance - Also known as "Part A," Medicare hospital insurance helps cover inpatient care in hospitals, including critical access hospitals, and skilled-nursing facilities, but not custodial or long-term care. It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits.

Medical Insurance - Also known as "Part B", most people pay a monthly premium for Medicare medical insurance. It helps cover doctors' services and outpatient care. It also covers some other medical services that Part A doesn't cover, such as some of the services of physical and occupational therapists, and some home health care.

Medicare Advantage - Also known as "Part C", Medicare Advantage plans are Medicare-approved private health insurance plans for individuals enrolled in Medicare Part A and Part B. They provide all of your Part A (hospital insurance) and Part B (medical insurance) coverage. They generally offer additional benefits, such as vision, dental, and hearing, and many include prescription drug coverage. These plans often have networks, which mean you may have to see certain doctors and go to certain hospitals in the plan’s network to get care. Each plan can vary in cost and coverage.

Prescription Drug Coverage - Also known as "Part D," most people pay a monthly premium for Medicare prescription drug coverage. Under Part D, beneficiaries choose among plans run by insurance or other private companies approved by Medicare. Each plan can vary in cost and drugs covered.

Related Resources

Special Bulletin
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The Centers for Medicare & Medicaid Services (CMS) May 22 released its final rule implementing policy changes for the Medicare Advantage (MA) and Part D…
Letter/Comment
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April 24, 2020 The Honorable Seema Verma Administrator Centers for Medicare & Medicaid Services Hubert H. Humphrey Building 200 Independence Avenue, S.W…
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The Centers for Medicare & Medicaid Services April 10 issued the proposed rule for the skilled nursing facility (SNF) prospective payment system for fiscal…
Letter/Comment
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The American Hospital Association appreciates the opportunity to comment on the Centers for Medicare & Medicaid Services’ proposed regulation regarding…