The Medicare Program provides health insurance for the elderly and disabled in the USA. It was first passed on July 30, 1965 as a set of amendments to Social Security.

Generally, Medicare is available for people age 65 or older, younger people with disabilities, and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant). People under 65 and disabled must be receiving disability benefits from either Social Security or the Railroad Retirement Board for at least 24 months before automatic enrollment occurs.

Medicare has two parts: Part A (Hospital Insurance), and Part B (Medicare Insurance, helps cover doctors' services, outpatient hospital care, and some other medical services that Part A does not cover).

In 2003, Medicare provides health care coverage for 40 million Americans. Enrollment is expected to reach 77 million by 2031, when the Baby Boom generation is fully enrolled.

It is administered by the Centers for Medicare and Medicaid Services (CMS) (formerly the Health Care Financing Administration) in the United States Department of Health and Human Services.

Medicare uses the Resource-Based Relative Value Scale (RBRVS) to determine how much money each doctor should earn, although it is criticized for not paying doctors enough because of the low conversion factor. Because of the nature of RBRVS, it is possible to pay all doctors more or less depending on how much money the person paying (CMS in this case) is willing to pay.

A prescription drug coverage was added in 2003 to take effect in 2006.

Unlike Medicaid, Medicare does not cover behavioral health services.

Legislation

• 1960 PL 86-778 Social Security Amendments (Kerr-Mill aid)
• 1965 PL 89-97 Medicare
• 1988 PL 100-360 Medicare Catastrophic Coverage Act
• 2003 HR 1, Medicare Prescription Drug, Improvement, and Modernization Act

See also:

• Medicaid
• Medicare (Australia)
• Medicare (Canada)
• Stark Law

External link

• http://cms.hhs.gov
• http://www.medicare.gov/