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What Is Medicare?

Medicare is the federally-funded health care program for disabled Americans and senior citizens. It was signed into law in 1965 by President Lyndon B. Johnson as an amendment to the Social Security Act.

Medicare is divided into separate parts. Each part provides a different kind of coverage — including hospital care, medical care, and prescription drugs.

Even though Medicare offers comprehensive coverage, it doesn't cover everything. To fill in coverage gaps, private insurance companies offer supplemental plans. You can also choose to buy Medicare coverage through private insurers instead of getting benefits from the federal government.

Let's take a closer look at all the parts of Medicare.

Medicare Part A and B

Medicare Part A and Part B provide the coverage for most medical care.

Medicare Part A covers in-patient hospital care and skilled nursing care. Patients get full coverage if they stay in a health facility for at least 3 days.

Part A covers care for one health condition up to 100 days. Beneficiaries won't need to pay anything for the first 20 days, but must pay a copayment for the next 80 days. But Part A does not provide coverage for long-term care or unskilled custodial care.

There are also no monthly premiums for Part A.

Medicare Part B provides coverage for most outpatient medical care, including:

  • Physician services
  • Lab and diagnostic tests
  • X-rays
  • Outpatient hospital care

Part B also covers the cost of medical equipment such as wheelchairs, walkers, prosthetics, and in-home oxygen.

Medicare Part B is optional for those working full time, but is mandatory for anyone not actively employed. A premium is paid each month for Part B coverage.

Medicare Part C - Medicare Advantage Plan

Part C plans were originally called "Medicare+Choice" plans, but now they're known as Medicare Advantage plans.

Part C was designed to give Medicare beneficiaries the option of buying coverage through a private health insurance company. These plans provide coverage for all the same services as Part A and B, but are administered by private carriers. These plans often include additional benefits.

Every year, an increasing number of people choose Part C. Today, almost 9 million Americans are enrolled in Medicare Advantage plans.

Medicare Part D

Medicare Prescription Drug plans — informally known as Medicare Part D — provide coverage for prescription medications. Before Part D was created, Medicare did not provide any coverage for medications.

Part D is an optional Medicare benefit — and it's administered by private insurers. The federal government sets certain requirements about the plans, but it's up to the private companies offering the plans to decide which drugs to cover.

To enroll in Medicare Part D, beneficiaries can choose a Prescription Drug Plan (PDP) or a Medicare Advantage plan that includes drug coverage (MA-PD).

Who Is Eligible For Medicare?

The majority of Medicare beneficiaries are seniors. But people with certain disabilities and illnesses can also get Medicare coverage.

You're eligible for Medicare if you:

  • Are at least 65 years old
  • Received Social Security for over 2 years
  • Have had disability benefits from the Railroad Retirement Board for over 2 years
  • Have kidney failure requiring permanent dialysis or need a kidney transplant
  • Have Lou Gehrig's disease (Amyotrophic Lateral Sclerosis)

You also must be an American citizen or have lived in the U.S. legally for 5 years or more.