In 1965, President Lyndon Johnson signed into law an amendment to the Social Security regulations and laws. This revision was known as Medicare. Originally, the were only two parts to the law. Hospital insurance was covered under Part A and medical insurance provisions came under Part B. By 2008, more than forty-five million individuals in the United States were enrolled in the program. Estimates of beneficiaries in 2030, when the baby-boomers are all under the auspices of the program, reach 78 million people. It is expected to be the largest social program of its kind on the planet.
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.
The program originally consisted of just Parts A and B. It was open to U. S. Citizens age 65 and higher. The individual must also have paid into the system for a minimum of ten years in order to avoid having to pay Part A premiums. The coverage under Part A is for inpatient hospital costs and related expenses. There will be a deductible applied. Under Part A, convalescent stays in the skilled nursing facility are covered. There can be co-payments required under some circumstances.
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 has only been in effect since 2006. This program covers stand alone prescription drug plans and some types of combination plans with components of Part C and Part D. Most of those who receive benefits under the program must pay both premiums and out-of-pocket expenses.
Premium costs for Part A enrollees are generally waived. Part B premiums in 2009 were $96.40 per month. These costs are automatically deducted from the Social Security benefit check. Part C and Part D premiums vary according to the program and the coverage. Some of the Part C plans rebate a portion of the Part B premium to 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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