The Medicare Program is a statewide social insurance program administered by the U.S. Federal Government and using about 30 private insurance companies across the United States. The program offers health insurance to people aged 65 or older who have worked and contributed into the system as well as to younger people with disabilities, end stage renal disease and amyotrophic lateral sclerosis.
Medicare offers 48 % of the health care charges for those who qualify; the remaining 52 % is covered either with supplemental insurance or with another form of out-of- pocket coverage. The out-of- pocket costs may vary according to the amount of health care a Medicare beneficiary may need. The Medicare Program has four parts: Hospital/Hospice insurance (Part A), Medical insurance (Part B), Medicare Advantage plans (Part C), Prescription drug plans (Part D).
Medicare allows the following out-of- pocket uncovered services:
- long-term care;
- dental care;
- hearing and vision care;
- supplemental insurance.
The Medicare Program requires that you meet the following conditions in order to become eligible:
- have 65 years of age or older;
- be a legal resident of the United States for at least 5 years;
- have a disability (even if you are under 65) and be the beneficiary of a Social
Security Disability Insurance (SSDI);
- get continuing dialysis for end stage renal disease;
- need a kidney transplant.
The Medicare Program allows those who are 65 or older and choose to enroll in Medicare Part A to pay a monthly premium if they or their spouse have not paid the qualifying Medicare payroll taxes. Otherwise, they cannot benefit of Medicare Hospital/Hospice insurance. The Medicare Program allows those who have disabilities and receive SSDI to be eligible for Medicare while they continue to receive SSDI payments. Otherwise, if they stop receiving SSDI, they lose eligibility for Medicare based on disability. All benefits offered through the Medicare Program are subject to medical necessity.
If you believe that you may be eligible, you may contact Medicare on the phone at 1-800- MEDICARE (1-800-633-4227) or you may access the Government’s official website. You can also use the Medicare mailing address: Centers for Medicare & Medicaid Services 7500 Security Blvd, Baltimore, MD 21244-1850.
If you want someone else to call on your behalf (at the official number 1-800-MEDICARE) or you want your personal information be given to someone else but you, you have to fill out a Medicare Authorization to Disclose Personal Health Information.