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Medicare Coverage

Medicare is a federally sponsored healthcare program that was established in 1965 through the Social Security Act along with its related federally sponsored health care program, Medicaid. Medicare is administered by the Centers for Medicare & Medicaid Services (CMS), currently providing health care services to more than 40 million Americans. Those eligible to receive benefits from Medicare include:

People 65 years of age or older
People with certain disabilities
People eligible for Social Security and/or Railroad Retirement benefits

Medicare coverage can basically be broken down into 2 parts: A & B. together, they makeup what is known as the Original Medicare Plan.

Part A is responsible for covering hospital stays, skilled nursing facility care, certain facets of general healthcare coverage, and hospice care.

Part B is responsible for covering the services provided by doctors, (Checkups, treatments etc.) outpatient hospital services, and other healthcare related services not necessarily covered through Part A.

Like most healthcare programs, Medicare has changed in numerous ways since its inception in 1965. One of the most notable changes comes with the addition of what has been commonly referred to as Part C, an addition that came in 1997 as part of the Balanced Budget Act.

Part C, otherwise known as the Medicare + Choice plan, contains managed care plans that are not unlike the more standard HMO plans, along with private plans that are somewhat similar to indemnity plans.

A few other notable changes that have affected Medicare more recently include:

Medicare Modernization Act: In 2003, created a new, voluntary discount card for purchasing prescription drugs. Estimates have suggested that the discount card could save recipients anywhere from 10% - 25% on the cost of covered drugs.

Transitional Assistance Program: If you have an annual income that is less than or equal to 135% of the federal poverty limit then your prescription drug discount card will come with a credit of $600 to be used for the purchase of covered drugs throughout a calendar year.

Medicare Obesity Coverage: In July 2004, Medicare changed its position on obesity now claiming it to be medical problem instead of a personal issue. Of the 40(+) million Americans on Medicare, approximately 37% are overweight and approximately 18% are obese.

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