Since 1965 when then President Lyndon Johnson signed it into law, Medicare has been a part of Social Security legislation. The original set of revisions had two parts, Part A or Hospital Insurance and Part B or Medical Insurance. As of 2008, 45 million Americans were enrolled in the single-payer program. By 2030, the baby boom generation is expected to be fully enrolled, bringing the number of enrollees to a projected 78 million individuals. The program size makes it the largest social service program of its type in the world.
Funding for the program is borne by employers and employees equally at a level of just under three percent of payroll. The governing legislation is the Self-Employment Contributions Act of 1954 for self employed individuals and the Federal Insurance Contributions Act (FICA). Self employed workers pay both the employer and employee portions.
In the original program, Part A referred to hospital insurance. Generally, anyone age 65 or higher who is a United States citizen and has paid into the system for at least ten years doesn’t need to pay Part A premiums. Part A pays for inpatient hospital costs, including doctor’s services after a deductible is paid. Part A also cover convalescent stays in a skilled nursing facility for a limited time. Some co-payments may be required, depending upon the length of the stay.
Medical costs are covered under Part B. This part of program coverage is optional, but there will be a penalty applied if you don’t enroll. Outpatient costs of all types are paid under Part B. These costs can be anything from seeing a physician to medical equipment to prosthetic equipment. Medications that are administered by a physician are covered.
Private insurance plans can be used to pay benefits under Part A and Part B, Part C became operable under the 2003 Prescription Drug, Improvement and Modernization Act. This part of the program adds the ability to cover prescription medications. The cost of Part C premiums are in addition to those of the original program parts.
Part D is the latest addition to the program. It was enacted into law in 2006. This portion of benefits law provides payment for prescription drug plans. It also allows for combining benefits from Part C for better coverage. This part requires additional payments for out-of-pocket expenses and monthly premiums.
Most Part A beneficiaries don’t have to pay premiums. The premiums for Part B are $96.40 monthly. These premium costs are automatically deducted from Social Security retirement benefits payments. The type of program and level of coverage determines the premium costs for Parts C and D. With some of the Part C plans, part or all of the Part B premium costs are returned to the enrollees.
The entire Medicare program is administered by the federal government. Complaints about fraud and abuse are common, but they are usually directed at hospitals, physicians and surgeons who bill the program for services. The changes in U. S. Law will affect the provision of services for health care in the future, but it remains to be seen what the extent of the changes will be.
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