Medicare at 65: Are You Eligible?

Medicare was established in 1965 to help provide healthcare coverage for the elderly in the United States according to Clearmatch Medicare. It is a federally administered program available to citizens or permanent residents who meet certain qualifications. Medicare offers different types of coverage, for which you must either be a part of a group plan through an employer or an individual with their plan that meets specific requirements.

To qualify for Medicare, you have to be 65 years old. You also have to have been a citizen or permanent resident for at least ten years before becoming eligible for Medicare. In addition, your income must be below specified limits, and you must not be enrolled in an affordable health care plan via your employer or Veteran's Administration coverage. Certain persons, such as people with terminal illnesses, may be eligible for additional benefits not available for others. Eligibility depends on certain financial requirements.

Medicare is an extremely expensive program with an annual price tag of $440 billion. The annual price tag is made up of the following:

• $100 billion to administer the program ($18 billion for Medicare itself and $188 billion for Medicaid). 
• $42.5 billion in hospital insurance payments ($17.3 billion for hospitals and $28.2 billion for medical care under Medicare).

You may not opt out of Medicare. However, there are ways to avoid paying some of the increased cost if you are eligible and want to join the program. The amount of income a person receives will determine their eligibility for Medicare. For most people, income is the primary factor determining whether they are eligible for Medicare and Medicaid. However, certain visual and hearing impairments may affect a person's ability to qualify or receive certain benefits under eligibility standards.

Several government programs cover different kinds of health care services and supplies that children may use in situations where no adult family member can or chooses to do so on their behalf. These programs include low-cost health insurance plans sponsored by individual states, federal programs, for instance, Medicaid, and the Children's Health Insurance Program (CHIP).

While Medicare does not offer dental or vision care coverage, CHIP does. Medicaid covers eye and/or vision care in each state through a managed care plan. Medicaid also provides coverage for children when their parents have low-wage jobs or are unemployed (not necessarily because of pregnancy) and unable to provide dental or vision care. Medicare is divided into Part B, and Part D. Part A covers hospital coverage for under $1,036 per month per person. Part A also covers the cost of outpatient services but does not cover long-term care or dental care. Medicare Parts B and D provide medical insurance or prescription drug coverage, respectively, to those age 65 and older.
​
The Medicare program serves as a role model for healthcare reform in other countries because of its degree of acceptability among the citizens it serves (e.g., it is consistent with people's ability to pay and their value system). Its success in reducing health care costs without damaging the quality of care is also a motivating factor.

Each state has a different program that offers health insurance plans for low-income people and little or no medical coverage. The main focus of this plan is to provide insurance for people who have children, although some plans may offer limited coverage for adults. In general, if you are under 65 and receive social security disability benefits, you may be eligible for Medicaid (usually the ones considered the "disabled").

Most of these programs cover care that is medically necessary. Examples of this include but are not limited to:

• Prescription drugs
• Eye care services
• Emergency room visits

Children, in general, are not entitled to all of the same health care benefits that adults have. The main exception to this rule is that all states have children's Medicaid programs (CHIP). CHIP provides benefits for children eligible for Medicaid but still have lower incomes than the eligibility requirements for most other government programs. As a result, some of these programs and services do not cover all of the same healthcare services available for adults. However, each state also has different requirements for their CHIP plan and may cover different services depending on a child's age.

For low-income families, Medicaid allows children and their parents to get medical care not covered by Medicare and CHIP. This means that if a parent has a health problem, such as diabetes or asthma, that can be treated with medication and/or health care, coverage for these services may be available under Medicaid. In general, children in low-income families will not have to pay deductibles or copayments from the program.

Medicare has transformed healthcare services provided in the US, covering so-called 'hidden populations' of poor and disabled people who are well below the poverty line. Healthcare coverage in Sweden, Norway, and Germany, for example, is means-tested, as it is in Australia. But unlike these countries, the US has opted for voluntarism as a way of extending coverage to low-income families: the gap between rich and poor is bridged by voluntary contributions from those with higher incomes. Families eligible for Medicaid may get assistance paying premiums on private health insurance plans through Medicare HealthChoice. State Medicaid agencies may provide information about the program and what it covers.

However, some services may not be covered by Medicaid, including long-term care and dental services, regardless of a person's age. Each state makes its own rules regarding coverage for Medicaid, so it is best to see what your state offers for children, as well as adults. Also, social work organizations or community health centers can help you find out if you are eligible for public health insurance programs such as Medicaid or CHIP.