Medicare is a social insurance program that was started by the US Federal government in 1965. The program was established with the objective of enabling Americans to have access to affordable healthcare (Umans & Nonnemaker, 2009). Medicare is funded through taxpayers’ money. The Self-Employment Contribution Act 1954 and the Federal Insurance Contribution Act empowers the Federal government to cut tax on workers and employers with a view to enhancing Medicare funding. A self-employed person is required to pay a tax of 2.9 percent from his or her net earnings (Umans & Nonnemaker, 2009).
Medicare spends an estimated15 percent of the US Federal budget. Based on current statistics, this amount is expected to increase by the year 2030 (Umans & Nonnemaker, 2009) mainly due to the fact that the U.S is experiencing a high rate of retirees, and this will result in an increase in the current aging population. Medicare does not work alone in the provision of healthcare insurance but it collaborates with different stakeholders with the objective of providing the best healthcare service to all members. Some of the services covered under the Medicare health insurance program include hospital care, home healthcare, hospital inpatient stay, skilled nursing facility and, Hospice care, among others (CMMS, 2011). The essay addresses Medicare, the demographics covered by Medicare, services offered by this organization, and the reason for choosing this agency for the study.
Description and demographics
Medicare is a health insurance program that covers American citizens of 65 years of age and above (CMMS, 2011). In addition, Medicare also covers people below the age of 65 years but who have certain disabilities. Other individuals covered under Medicare are persons with end-stage renal disease regardless of their age (Umans & Nonnemaker, 2009). One of the main requirements for consideration as a member of Medicare is to have been legally residing in the US for a period of not less than 5 years. However, people with disability can benefit from the Social Security Disability Insurance scheme regardless of their age. In case the disabled member is married, the spouse is expected to have been paying taxes for a minimum period of ten years. Another eligibility requirement for persons with disabilities is that they ought to have received the SSDI benefits for a minimum period of 24 months. This means that people with disabilities have to wait for at least two years before they are eligible for the program (Santerre & Neun, 2010). In the case of a spouse who has not been paying taxes for the last ten years, the eligible party is expected to pay a premium on a monthly basis to be covered under the healthcare insurance program. The program covers more than 45 million Americans and the number is expected to increase by 2030 (Umans & Nonnemaker, 2009) because the elderly population in the US is increasing rapidly.
According to Umans and Nonnemaker (2009), the population covered under Medicare has continued to increase rapidly as persons aged 65 years and above continue to increases. An estimated 7.3 million persons with disability have thus far benefited from the Medicare program. In the United States, the life expectancy among women is high compared to that of men (Umans & Nonnemaker, 2009). This implies that more women compared to men benefit from the health insurance program. From a racial context, Whites are the main beneficiaries of the Medicare program followed by Blacks and Hispanics, respectively (Umans & Nonnemaker, 2009). In addition, more than half of the Medicare beneficiaries (51 percent) have a high school diploma, while 41 percent of the Medicare beneficiaries have received a college education. More than half of the beneficiaries of the Medicare program live with their spouses, 5 percent live in a health institution, and 48 percent are either not married or widowed (Umans & Nonnemaker, 2009). Compared with rural residents, urban residents form the largest share of Medicare health insurance. Medicare mainly covers poverty-stricken individuals whose income is less than the 200 percent poverty level threshold set by the Federal government.
The Medicare health insurance program offers different services under different subsets of the program. They include Medicare part A, Medicare part B, Medicare part C, Medicare part D. Medicare part A is also referred to as hospital insurance. It covers
services such as home healthcare, hospice, skilled nursing facilities, and inpatient hospital care to eligible members (CMMS, 2011). Eligible beneficiaries are not required to pay any premiums if their spouses paid taxes while they were employed. On the other hand, Medicare part B deals with home healthcare and outpatient hospital care. Other services covered include durable medical equipment and covering of healthcare providers and doctors’ services (Santerre & Neun, 2010). In addition, Medicare provides preventive services cover to its members.
Medicare part B is also referred to as Medicare advantage. This program provides optional Medicare healthcare plans which have been approved by private insurance companies (Santerre & Neun, 2010). Through Medicare part C, beneficiaries can get Medicare part A and Medicare part B services under one package but from the private sector. Medicare part D provides a prescription for drugs. However, in order for one to receive all these services, he or she has to incur an extra cost for extra benefits (CMMS, 2012). Medicare part D is also referred to as the Medicare Prescription Drug Coverage (CMMS, 2011). As the name suggests the program covers the cost of prescription drugs. In addition, it helps in lowering the cost of prescription drugs and at the same time help in protecting against the high cost of prescription drugs (CMMS, 2011). In other words, Medicare Part D ensures that patients covered are not exploited financially. Generally, Medicare part D pays for medicines prescribed to patients under the Medicare program.
Medicare has been chosen because it provides healthcare insurance cover to the aged generation and persons with disabilities. In addition, most persons under this program live below the poverty line and cannot afford healthcare insurance coverage from private insurance companies. Although Medicare is funded through taxpayers’ money, it also acts as a lifesaver for the old and/or disabled. Lastly, the program has been chosen because the US has the highest aging population that requires medical and nursing attention.
To sum it up, Medicare is a healthcare insurance program that is dedicated to providing insurance cover to persons aged 65 years and above. It also covers persons with disabilities regardless of their age. Whites are the majority beneficiaries followed by Blacks and Hispanics, respectively. Different services are provided under this program under different subprograms including Medicare part A, Medicare part B, Medicare part C, Medicare part D. Some of the benefits of Medicare include outpatient and inpatients healthcare, preventive services, Medicare advantage, medical insurance, home healthcare, and Medicare prescription drug cover.
CMMS. (2011). What is Medicare? Centers for Medicare & Medicaid Services. Web.
Santerre, R. E., & Neun, S. P. (2010). Health economics: theories, insights, and industry studies. Mason: South-Western Cengage Learning.
Umans, B & Nonnemaker, K, L. (2009). The Medicare beneficiary population. Washington: AARP Public Policy Institute.