What is Medicare (in the United States) ?

In the United States, Medicare refers to a national health insurance program administered by the Centers for Medicare and Medicaid Services (also known as CMS). It provides health insurance coverage for United States citizens over the age of 65, as well as younger individuals with disability status. This disability status is determined by the SSA. Medicare can also provide health insurance coverage to those with end stage renal disease and amyotrophic lateral sclerosis (also known as ALS.)

Medicare has provided health insurance to over 59.9 million people on average annually, with more than 52 million of those covered beingsenior citizens. Medicare, according to Medicare Trustees reports via MedPAC group, covers around half of the healthcare expenses of those enrolled in the program. Those enrolled have to cover those remaining costs by utilizing additional private insurance plans or joining a public Part C or D Medicare plan.

Individuals on Medicare will still have to cover additional health care related fees and costs, including deductibles, co-pays, and the costs of uncovered services such as long-term care. The program is funded by a mix of payroll tax, beneficiary premiums, and surtaxes.

Essentially, the program can be broken down into four groups:

  • Part A – Covers hospital, nursing, and hospice services.

  • Part B – Covers outpatients services, outpatient hospital charges, prescription drugs, and provider office visits.

  • Part D – Covers self-administered prescription drugs.

  • Part D – Serves as an alternative plan called Medicare Advantage that lets patients choose health plans with the same service covers as Part A and Part B.



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