Eligibility for Medicare

Eligibility for Medicare

1. What about services that are not provided through Medicare?

MediGap plans offer supplemental coverage for medical expenses and services that are not covered by Medicare. The Centers for Medicare and Medicaid Services have authorized private companies to sell and administer the 12 plans of MediGap. MediGap plans are no longer able to include drug coverage since the availability of Medicare Part D.

2. Who is eligible for Medicare?

To be eligible for Medicare, an individual must either be at least 65 years old, under 65 and disabled, or any age with End-Stage Renal Disease. In addition, eligibility for Medicare requires that an individual is a U.S. citizen or permanent legal resident for 5 continuous years and have worked for at least 10 years in a job that has paid money into the Medicare system.

3. Who pays for services provided by Medicare?

Payroll taxes collected through FICA (Federal Insurance Contributions Act) and the Self-Employment Contributions Act are a primary component of Medicare funding. The tax is 2.9% of wages, usually half paid by the employee and half paid by the employer. Moneys are set aside in a trust fund that the government uses to reimburse doctors, hospitals, and private insurance companies. Additional funding for Medicare services comes from premiums, deductibles, coinsurance, and copays.