Medicare
Medicare is the public and state health insurance within the US healthcare system for elderly or disabled citizens. Medicare was on July 30 in 1965 by additions to the Social Security Act as part of the Great Society into the social security system of the United States inserted and is in addition to the pension, the second federal insurance. Medicare is available to anyone aged 65 and over and anyone with a recognized disability or acute kidney failure that requires permanent dialysis or a kidney transplant.
In addition, there is Medicaid , a tax-funded health care program for low-income citizens.
Types of insurance
The insurance originally consisted of two parts:
- Part A comprises Hospital Insurance (HI) , also known as Medicare Part A , a compulsory insurance for hospital treatment , financed in equal parts by employers and employees. The treatment includes inpatient care in clinics, in nursing homes inpatient care without care and long-term care and hospice services.
- Part B is the Supplementary Medical Insurance (SMI) , also known as Medicare Part B , a supplementary voluntary insurance for outpatient treatment , financed by monthly contributions from the employee (medical insurance).
Medicare insurance does not guarantee full cost coverage , but provides various forms of deductible. Benefits for certain medications, visual aids, dental treatments and hearing aids are not reimbursed. The hospital costs are 85% covered. Medical services have an excess of 20% and an annual one-off payment. That is why the majority of citizens over 65 also have private supplementary health insurance to cover the deductibles. The Medicare Catastrophic Coverage Act of July 1, 1988 reduced hospital and medical care deductibles, improved nursing care treatments, and introduced reimbursement for certain drugs. Financing was provided through premium increases.
In 1993, President Bill Clinton attempted to reform Medicare as part of an ambitious program, but failed.
The Balanced Budget Act of 1997 was designed to reduce spending on Medicare costs. With the
- Part C, the Medicare Advantage (MA) or Medicare Part C insurance, can thus be assigned part of the state benefits to private health insurance companies, and Medicare pays a certain amount for each member to the private health insurance companies, which also take care of the sales. The policyholder supplements the contributions and can offer individual additional services, e.g. B. Pay for certain prescription drugs.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 introduced a fourth part of Medicare insurance. With
- Part D, the Medicare Prescription Drug Coverage or Medicare Part D , should in turn reduce government costs and fund additional services through private health insurance. Since 2006, policyholders have been able to choose between two plans: a Prescription Drug Plan (PDP) to partially cover the costs of medication or Services and Prescription Drugs (MA-PD) to partially cover the medical services and medication. The policyholder can decide which specific medication or class of medication and what level of coverage or which ones are excluded.
financing
To finance Medicare, a nationwide levy of 2.9 percent is levied on wages and self-employed income.
In 1999 the federal budget (Federal Budget) for Medicare alone comprised 190.45 billion US dollars and in 2010 it stood at 453 billion US dollars, which means a share of the total federal budget of 12.8 percent. In 2009, around 45 million citizens were covered by Medicare.
The remuneration of medical services determine the Centers for Medicare and Medicaid Services based on suggestions of in the American Medical Association settled Specialty Society Relative Value Scale Update Committee (RUC) .
Web links
Individual evidence
- ^ Haley Sweetland Edwards: Special Deal , Washington Magazine, July / August 2013