Medicare is a national healthcare insurance plan based on Medicare for 65 and older. Some people under the age of 60 may also be eligible to receive Medicare. This program provides for health care costs, but does not cover medical expenses and long-term care costs.
The way Medicare is covered is your choice. Those who want Medicare Part A coverage or Part C coverage may choose a Medicare supplement insurance (Medigap) plan from a private insurance provider.
Medicare provides coverage for items and services for over 55 million beneficiaries. The vast majority of coverage is provided on a local level and developed by clinicians at the contractors that pay Medicare claims.
However, in certain cases, Medicare deems it appropriate to develop a National Coverage Determination (NCD) for an item or service to be applied on a national basis for all Medicare beneficiaries meeting the criteria for coverage.
This page provides general information on various parts of that NCD process, resources of both a general and historical nature, and summaries and support documents concerning several miscellaneous NCDs.
Whenever a person starts enrolling for Medicare, you can select a mode of coverage. Medicare is available in 3 main parts: part A or part B.
Some patients may be eligible for additional insurance, such as Medicare drugs insurance or Medicare Supplements Insurance (medicare). Use this list of information and tips for comparing coverage options.
Eligibility depends on a number of criteria, but in general, anyone who has lived in the United States legally for at least five years and is age 65 or older qualifies for Medicare coverage.
Enrollment in Parts A and B is automatic for anyone who receives Social Security benefits. Part D coverage is optional, and enrollment must be done by the individual.
People under age 65 may qualify if they receive Social Security Disability Insurance (SSDI). Those who receive SSDI generally need to wait 24 months after they receive their first check before they become eligible for Medicare, although the program waives this requirement for anyone with ALS and or with permanent kidney failure. Enrollment can be done through the Social Security Administration (SSA) website.
Premiums for Medicare Part A are free if an insured person or their spouse contributed to Medicare for 10 or more years through their payroll taxes. You are responsible for paying premiums for other parts of the Medicare program.
The program is funded through a variety of sources. U.S. taxpayers contribute to the program through the Federal Insurance Contributions Act (FICA), which goes toward Social Security and Medicare deductions.
As of 2021 and 2022, employees contribute a total of 7.65% of their paychecks to these programs 6.2% to Social Security and 1.45% to Medicare. Employers also pay the same percentage on behalf of each employee.
Find all your Medicare questions and answers. Get some advice about getting Medicare coverage while living overseas. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. If you have a Medicare health plan, your plan may cover them.
Related Resources Getting care & drugs in disasters or emergencies Find out who to call about Medicare options, claims and more. Even if You Are Not Ready to Retire Help Fight Medicare Fraud Get Extra Help with Medicare prescription drug plan costs More Medicare information Understanding Medicare Part C & D Enrollment Periods Choosing a Medigap Policy
If your Medicare coverage does not cover your medical expenses, you may be obligated later for a premium. Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance).
This could trigger an unlimited premium on Medicare drug coverage. Find a detailed overview of the origin and effect of Original Medicare. Some Medigap policies offer coverage when you travel outside the U.S. Generally, Medigap policies don't cover long-term care (like care in a nursing home), vision, dental, hearing aids, private-duty nursing, or prescription drugs.
Part D of Medicare offers prescription medicine. Find out how much Medicare insurance covers your prescription medications. Summary Missing Your Medicare coverage choices Learn about the 2 main ways to get your Medicare coverage Original Medicare or a Medicare Advantage Plan (Part C).
Medicare Advantage Plans provide all of your Part A and Part B benefits, with a few exclusions, for example, certain aspects of clinical trials which are covered by Original Medicare even though you're still in the plan.
Can Medicare card replacements be made when the card is stolen, damaged or lost. What Part B covers Learn about what Medicare Part B (Medical Insurance) covers, including doctor and other health care providers' services and outpatient care.