An Introduction to Medicare in the United States

An Introduction to Medicare in the United States

In the United States, medical care can be incredibly expensive and, in many cases, only becomes more expensive with age and for those who have pre-existing conditions. Since the 1960s, the federal government has assisted the elderly through the Medicare Program, which is a type of socialized health insurance that significantly increases the number of insured seniors in the US. Medicare is a federally administered insurance program whose primary purpose is to provide medical insurance to people over 65. It is part of the Social Security program and was first created in 1965.

The main requirement for receiving Medicare is that the person is over 65 and has been a legal resident of the United States for at least five years. As long as the recipient, or his spouse, has paid the Federal Medicare System for at least ten years as part of payroll taxes, only a limited monthly premium may be required. Otherwise, if the insured has not paid payroll taxes, he will receive a higher monthly premium. While the primary intention is to provide affordable medical care for the elderly, other people are also covered by Medicare. For example, people with disabilities may qualify for Medicare, especially if they have advanced kidney disease or Lou Gehrigs disease.

Medicare benefits can be quite broad and can cover many conditions and instances. For example, most doctor visits and emergency services are covered, as well as glasses, canes and wheelchairs, which are considered durable medical equipment. Of course, there are some restrictions on all of these items, and in some cases a copayment is required. For example, while assisted living is often covered, the nursing home must meet federal guidelines and be classified as a specialized center. Over the past twenty years, private insurance has also entered the Medicare industry, with alternatives to the federal Medicare program available. These plans, called Medicare Advantage plans, must comply with several federal regulations and are funded by the federal government, but the program itself is run by private insurance companies.

Medicare Advantage plans may offer some advantages, but it is important to be careful when choosing one and comparing your plans with those offered by traditional Medicare. Although they must comply with federal guidelines, they have room to choose how to comply with them, so that they may have a higher premium for something like long-term nursing care, while offering cheaper prescription drugs. Another recent change in Medicare is improved coverage of prescription drugs. Prior to 2006, Medicare prescription drug coverage left something to be desired and, as a result, a law was passed to extend care. Medicare beneficiaries can now apply for a private prescription drug plan designed to cover the cost of most prescription drugs.