What Is Medicare?
NOTE: Glossary words are highlighted. Click on any glossary word to see its definition.
What is Medicare?
Medicare is a federal health insurance program that provides health care coverage to most people age 65 and older, certain people under 65 with disabilities, and people with end-stage renal disease (ESRD). Medicare currently provides coverage to about 40 million Americans.
Medicare is basic protection, and does not cover all medical expenses or most long-term care. Medicare is divided into two parts, Part A Hospital Insurance and Part B Medical Insurance. Medicare Part A and Part B together are often called the Original Plan. People with Part A and Part B can enroll in a Part C Medicare Advantage Plan. People with Part A and Part B can enroll in a Part D Prescription Drug Plan.
Who runs Medicare?
Medicare is run by the Center for Medicare and Medicaid Services (CMS), an agency of the United States Department of Health and Human Services. While CMS operates the Medicare program, the Social Security Administration determines Medicare eligibility. The rules for Medicare are the same all over the country.
Medicare Part A is funded mostly by federal payroll taxes paid to Medicare by employers and employees.
Medicare Part B is funded by monthly premiums paid by people receiving Medicare Part B, plus a subsidy from the federal government.
Who is in charge of fraud prevention?
The Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) is in charge of Medicare fraud prevention. You can report Medicare fraud in these ways:
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Call the OIG Hotline at 1-800-HHS-TIPS (1-800-447-8477), TTY: 1-800-377-4950
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Send a fax to the OIG at 1-800-223-8164
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E-mail the OIG at HHSTips@oig.hhs.gov
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Send a letter to:
HHS TIPS Hotline
P.O. Box 23489
Washington, DC 20026
You do not have to give your name. You should include the type of fraud, and whatever information you have about the person or organization that is committing the fraud.
Is Medicare the same as Medicaid?
No. Medicare and Medicaid are different programs.
Medicare helps pay for medical care for people over 65 who get Social Security or Railroad Retirement benefits; certain disabled people under 65 who get disability payments; and people with end-stage renal disease (ESRD). You can get Medicare if you or your spouse have worked enough years in Medicare-covered jobs, regardless of your income. Medicare benefits are the same throughout the United States.
Medicaid is a health care program for people with limited incomes. It provides health coverage for a wide range of people, including families and individuals under age 65. Eligibility depends on your financial resources, not your work history. Benefits vary from state to state within broad federal guidelines.
If you are eligible for Medicaid and also for Medicare, Medicaid will pay some or all of your Medicare costs.
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