The Centers for Medicare & Medicaid Services (CMS) administers Medicare, the nation's largest health insurance program, which covers nearly 40 million Americans.

Medicare is a health insurance program for people 65 years of age and older, some disabled people under 65 years of age, and people with end-stage renal disease (permanent kidney failure treated with dialysis or a transplant).

Who Is Eligible for Medicare?

After a person turns 65, he or she is eligible for Medicare if he or she has worked (or his or her spouse has worked) and has had taxes taken out of his or her paychecks for Medicare.

Certain workers who become severely disabled before age 65 and no longer can work are also eligible for Medicare. These individuals, however, must wait for 29 months from the time the Social Security Administration determines they have a severe and permanent disability until they can begin to receive benefits. 

People with amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease) and persons with end-stage renal disease (ESRD or kidney failure) are also qualified for Medicare coverage.

Additionally, certain dependent adult children of Medicare beneficiaries are eligible for Medicare if they developed a permanent and severe disability before age 22.

Applying for Medicare

Medicare enrollment is automatic. The United States’ birthday present for those who turn 65 is the automatic enrollment to Medicare Part A and B. A Medicare card will arrive in the mail about three months before the 65^th birthday, and enrollment begins the first day of the month the individual turns 65. Individuals may decline Part B coverage, but having the coverage may be an added protection.

People who did not work enough years in the United States to pay for Medicare coverage, may still enroll in Medicare. However, they will need to pay premiums for the coverage.

History of Medicare & Medicaid

Congress created Medicare and Medicaid in 1965 to provide health coverage to workers 65 years old or more and qualifying people with low-incomes.

 On December 8, 2003, President Bush signed into law the Medicare Modernization Act (MMA), a law that helps Medicare move into the future. The new plan signed into this act is known as “Medicare Part D.” Medicare Part D covers drug prescription costs.

The traditional parts of Medicare—Parts A, B, and C, have not changed.

Medicare Parts

• Part A: Covers inpatient hospital care, home healthcare, and hospice care.
• Part B: Covers physician care, other outpatient hospital services, and drugs provided in the physician’s office.
• Part C: Provides for managed care options (formerly known as Medicare + Choice). Now called “Medicare Advantage,” this part includes items and services covered by Parts A, B, and D.
• Part D: Covers outpatient prescription drugs.

Resources

More information on Medicare is available online from the following Websites:

• www.medicare.gov
• www.ssa.gov
• www.cms.hhs.gov
• www.medicarerxeducation.org
• www.kff.org

For more information about Medicare and other programs specific to seniors, please go to AARP, or call:

1. Medicare 800-633-4227; TTY 877-486-2048
2. Social Security Administration 800-772-1213; TTY 800-325-0778