Medicare is one of the government funded federal healthcare programs available. It provides insurance for citizens who meet specific criteria, namely those who are aged 65 and over, people under 65 who have certain disabilities, and people who have End-Stage Renal Disease, which is a form of permanent kidney failure which requires constant dialysis or an organ transplant.

Eligibility

Medicare insurance policies are not provided to everyone; each applicant must meet a certain set of criteria before they can begin receiving Medicare benefits.

These criteria include:

  • They are 65 years or older andS. citizens or have been permanent legal residents for 5 years, andthey or their spouse (or qualifying ex-spouse) has paid Medicare taxes for at least 10 years.
  • They are under 65, disabled, and have been receiving either Social Security SSDI benefits or Railroad Retirement Board disability benefits; they must receive one of these benefits for at least 24 months from date of entitlement (eligibility for first disability payment) before becoming eligible to enroll in Medicare.
  • They are receiving constant dialysis for end stage renal disease or are requiring a kidney transplant.
  • They are disabled and are receiving SSDI. This group are only eligible for Medicare whilst they are receiving their Disability payments. Some beneficiaries are dual-eligible, and they qualify for both Medicare and Medicaid. In some states for those who earn below a certain income, Medicaid will pay the person’s Part B premium for them, as well as some of their out of pocket medical and hospital expenses.

 

The Medicare Program

Part A – Hospital Insurance

  • Inpatient care if admitted to hospital
  • Terminal/End of life hospice care

Part B – Medical Insurance

  • Doctor or other healthcare providers services

Part C – Medicare Advantage

  • All of the services provided in parts A & B
  • Will usually cover prescription drugs (Part D)

Part D – Medicare Prescription Drugs Coverage

  • Helps cover the cost of prescription drugs