Who are eligible for Medicare?

Medicare is a federal program conceived for the purpose of providing healthcare for the disabled and the older population in the country aged above 65 years. It is a basic health insurance program which provides financial protection against major costs resulting from hospital and related care, including everything from skilled nursing facility to home health and hospice care. Medicare demands people to enroll themselves in the scheme and its services also include a supplementary medical insurance program by which patients are lend a helping hand in paying all forms of healthcare bills in terms of wheelchairs, doctors’ services, and laboratory and x-ray services. Medicare is managed and administered by The Centers for Medicare and Medicaid Services, a department of the Department of Health and Human Services (HHS).

Old age can be a difficult phase in any one’s life. It is a time when the agility of body and mind loses the vigor of yesteryears and almost every physical movement and function takes longer in time to respond to the brain stimulus. Definitely, it is a phase which demand more care from others, especially nearest family members. But, as young chaps, they might have contributed their share and played their parts in building the nation and now it is the duty of the nation – its younger generation – to pay back or take care of them. It was such a line of thought that had eventually resulted in the conceptualization of Medicare. Support for the disabled was incorporated to the clause in 1973.

After much deliberations and discussions, when Medicare was finally introduced, it was a major step towards extending medical care to the senior citizens of United States of America. It was introduced into effect by the passage of the Social Security Amendments legislation by President Lyndon Johnson in 1965. As per the available statistics, at least 50 millions American senior citizens enjoy the cover of Medicare.

It has been mentioned that Medicare is for the old people, those falling in the age group of above 65 years. But what are the eligibility conditions for applying for Medicare or who all are qualified to claim Medicare services?

Medicare is funded through taxation on the earnings of the employee which is matched by premiums paid by those who have enrolled and the employer himself. The federal healthcare program subsidizes people who agree with any of these criteria.

  • A person – aged 65 years or above – and who is a citizen of US or a legal resident of the country for a minimum of five years.
  • A disabled person and has received Social Security for at least two years.
  • An individual with a chronic kidney failure that demands constant dialysis.
  • A person who is crippled by ALS-Lou Gehrig’s disease.

Beyond these stated conditions, Medicare also reaches out to people at a time when they may be having serious healthcare troubles but not have the financial backing to pay for the treatment.

But Medicare has some short comings as well. It does not cater to people who are below 65 years of age but sufficiently old. Also, the percentage of cost covered by Medicare is as low as 56% of the total expense.

From the foregoing analysis and statement of facts it becomes clear that meanwhile Medicare is a big boon for the old people, it also fails to reach out to the people in a much bigger scale in terms of financial assistance provided. That is, it needs some sort of a revamp of its policies so that it will benefit the lot, who cannot fund for their treatments in the old age, keeping in mind that old age exists below 65 as well. Let us hope that things will emerge for the better at the earliest!