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单词 medicare
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Medicare


Med·i·care

also med·i·care M0191300 (mĕd′ĭ-kâr′)n. A program under the US Social Security Administration that reimburses hospitals and physicians for medical care provided to qualifying people over 65 years old.
[medi(cal) + care.]

Medicare

(ˈmɛdɪˌkɛə) n1. (Social Welfare) (in the US) a federally sponsored health insurance programme for persons of 65 or older2. (Social Welfare) (often not capital) (in Canada) a similar programme covering all citizens3. (Social Welfare) (in Australia) a government-controlled general health-insurance scheme[C20: medi(cal) + care]

Med•i•care

(ˈmɛd ɪˌkɛər)

n. 1. (sometimes l.c.) a U.S. government program of medical insurance for aged or disabled persons. 2. (l.c.) any of various government-funded programs to provide medical care to a population. (medi (cal) + care]

Medicare

A health insurance program for people over 65 years old, under which the government pays the medical expenses of qualifying people.
Thesaurus
Noun1.Medicare - health care for the agedMedicare - health care for the aged; a federally administered system of health insurance available to persons aged 65 and overhealth care - social insurance for the ill and injured
Translations
Krankenversicherung

Medicare


Medicare,

national health insurance program in the United States for persons aged 65 and over and the disabled. It was established in 1965 with passage of the Social Security Amendments and is now run by the Centers for Medicare and Medicaid Services. Coverage for certain people with disabilities began in 1973. Medicare provides for a basic program of hospital insurance, under which enrollees are protected against major costs of hospital and related care; and a supplementary medical insurance program, through which persons are aided in paying doctor bills and other health-care bills. It is funded by a tax on the earnings of employees that is matched by the employer and by premiums paid by enrollees. In 2012 some 51 million Americans were enrolled in Medicare. Legislation passed in 2003 provides for a drug benefit program (beginning in 2006), higher premiums for enrollees earning more than $80,000, and subsidies over 10 years to encourage private insurers to compete with Medicare.

Medicare

U.S. program of health insurance for the aged. [Am. Hist.: EB, VI: 747]See: Aid, Governmental

Medicare


Medicare

 [med´ĭ-kar] a program of the Social Security Administration which provides funding for medical care to the aged and to certain others.

Medicare

also

medicare

(mĕd′ĭ-kâr′)n. A program under the US Social Security Administration that reimburses hospitals and physicians for medical care provided to qualifying people over 65 years old.

Medicare

A national (USA) social insurance program, administered by the federal government since 1965, that guarantees access to health insurance for Americans ages 65 and older, younger people with disabilities, and people with end stage renal disease.
Components of Medicare
▪ Part A: Hospitalisation insurance—Financed by contributions from employers, employees and participants.
▪ Part B: Medical insurance—Covers outpatient services, financed in part by monthly premiums paid by enrollees and by the federal government.
▪ Part C: Medicare Advantage Plans—Allows Medicare beneficiaries the option of receiving their benefits through private health insurance plans, instead of through the original Medicare plan.
▪ Part D: Prescription Drug Plans—Not standardised and can be tailored to individual needs.

Medicare

Managed Care A federal program run by HCFA/CMS that provides hospital and medical insurance protection for a significant minority in the US Components-Part A Compulsory hospitalization insurance, financed by contributions from employers, employees, and participants; Part B Voluntary supplementary medical insurance, which covers outpatient services, financed in part by monthly premiums paid by enrollees and by the federal government. See HCFA, HMO, Part A, Part B. Cf Medicaid, Socialized medicine.

Med·i·care

(med'i-kār) 1. A national health insurance plan managed by the U.S. government that covers Social Security and Railroad Retirement beneficiaries age 65 years and older, people who have been entitled for at least 24 months to receive Social Security or Railroad Retirement disability benefits, and some people with end-stage renal disease; established in 1965 by an amendment to the Social Security Act.
Compare: Medicaid
2. The universal public health insurance system of Canada, administered by the provincial governments under guidelines set by the Canadian federal government; initiated under the Canada Health Act in 1984. 3. A national public health insurance system in Australia; provides for free care in public hospitals, and free or subsidized care in clinical settings for certain conditions; established in 1984.

Med·i·care

(med'i-kār) 1. A national health insurance plan managed by the U.S. government that covers Social Security and Railroad Retirement beneficiaries age 65 years and older, people who have been entitled for at least 24 months to receive Social Security or Railroad Retirement disability benefits, and some people with end-stage renal disease; established in 1965 by an amendment to the Social Security Act.
Compare: Medicaid
2. The universal public health insurance system of Canada, administered by the provincial governments under guidelines set by the Canadian federal government; initiated under the Canada Health Act in 1984. 3. A national public health insurance system in Australia; provides for free care in public hospitals, and free or subsidized care in clinical settings for certain conditions; established in 1984.

Medicare


Related to Medicare: Medicaid, Medicare and Medicaid

Medicare

A federally funded system of health and hospital insurance for persons aged 65 and older and for disabled persons.

The Medicare program provides basic health care benefits to recipients of Social Security and is funded through the Social Security Trust Fund. President Harry S. Truman first proposed a medical care program for the aged during the late 1940s, but Medicare was not enacted until 1965, as one of President Lyndon B. Johnson's Great Society programs (42 U.S.C.A. §§ 1395 et seq.).

Medicare went into effect in 1966 and was first administered by the social security administration. In 1977, the Medicare program was transferred to the newly created Health Care Financing Administration (HCFA). The HCFA is concerned with the development of policies, programs, procedures, and guidance regarding Medicare recipients, the providers of services—such as hospitals, nursing homes, and physicians—and other organizations that are closely related to the Medicare program.

Unlike other federal programs, Medicare is not supported by a large, federal organizational hierarchy. The federal government enters into contracts with private insurance companies for the processing of Medicare claims. Health care providers must meet state and local licensing laws and standards set by the HCFA in order to qualify for Medicare payments for their services.

Eligibility for Medicare does not depend on income. Almost everyone aged 65 and older is entitled to Medicare coverage. Disabled persons under age 65 may receive Medicare benefits after they have been collecting Social Security or railroad disability payments for at least two years. Workers do not have to retire at age 65 in order to be protected by Medicare. People who have not worked long enough under Social Security to receive retirement benefits may enroll in the plan by paying a monthly premium. For those individuals who are not covered under Social Security and who are too poor to pay the monthly premium, Medicaid, the state and federal program for low-income persons, is available.

Medicare is divided into a hospital insurance program and a supplementary medical insurance program. The Medicare hospital insurance plan is funded through Social Security payroll taxes. It covers reasonable and medically necessary treatment in a hospital or skilled nursing home, meals, regular nursing-care services, and the cost of necessary special care. Medicare also pays for home health services and hospice care for terminally ill patients.

The hospital insurance program extends coverage based on "benefit periods." An episode of illness is termed a benefit period and starts when the patient enters the hospital or nursing home facility and ends 60 days after the patient has been discharged from the facility. A new benefit period starts with the next hospital stay, and there is no limit to the number of benefit periods that a person can have. In any benefit period, Medicare will pay the cost of hospitalization for up to 90 days. The patient must pay a one-time deductible fee for the first 60 days in a benefit period and an additional daily fee called a co-payment for hospital care for the following 30 days. Apart from these payments, Medicare covers the full cost of hospital care.

Medicare also pays for the first 20 days of care in a skilled nursing home and for expenses exceeding a daily minimum amount for the next 80 days when certain conditions show that such care is necessary. Payment also may be made for up to 100 home-health visits provided by a home-health agency for up to 12 months after the patient's discharge from a hospital or nursing home, provided that certain conditions apply.

Medicare's supplementary medical insurance program is financed by monthly insurance premiums paid by people who sign up for coverage, combined with money contributed by the federal government. The government contributes the major portion of the cost of the program, which is funded out of general tax revenues. Persons who enroll pay small, annual, deductible fees for any medical costs incurred above that amount during the year, and also a regular monthly premium. Once the deductible has been paid, Medicare pays 80 percent for any bills incurred for physicians' and surgeons' services, diagnostic and laboratory tests, and other services. Doctors are not required to accept Medicare patients, but almost all do. Payments may not be made for routine physical checkups, drugs and medicines, eyeglasses, hearing aids, dentures, or orthopedic shoes.

Medicare bases its 80 percent payment for medical expenses on what is considered to be a reasonable charge for each kind of service. The reasonable charge is an amount that is determined by the insurance organizations that process Medicare claims for the federal government, based on the customary charge for that service in that part of the country.

Medicare payments may be sent directly to the doctor or provider of the service or to the patient. In 1994, 93 percent of all charges to Medicare patients for covered physician services were billed directly to the insurance systems rather than to the patients themselves. Thus, few patients need to be reimbursed for payments that they had made directly to the physician or another provider of services. Under either method, the patient receives a notice after the doctor or provider files a medical insurance claim. The notice details the medical service and explains the expenses that are covered by Medicare and are approved; how much of the charge is credited toward the annual deductible amount; and how much Medicare has paid. A person who disagrees with the decision on the claim may ask the insurance company to review the decision. A formal hearing may be held on claims that, if paid, would total at least $100. Cases that involve $1,000 or more can eventually be appealed to a federal court.

The financial future of Medicare has been a hotly debated issue since the 1980s. In 1995, Medicare covered 37 million people. The number of people eligible for Medicare will continue to rise as the post–World War II baby boom generation begins to retire.

Other factors have had an impact on the financial future of Medicare. The quality of medical care has increased life expectancies. Nearly three years have been added to life expectancies since Medicare was created. Modern medicine is likely to continue this trend, which means that Medicare will be taking care of people for longer. Another factor is the increased cost of medical care itself, which takes more resources out of the system.

Medicare's hospital insurance is financed by a payroll tax of 2.9 percent, divided equally between employers and workers. The money is placed in a trust fund and is invested in U.S. Treasury Securities. A surplus accumulated during the 1980s and early 1990s, but the program's outlays are projected to rise more rapidly than the future payroll-tax revenues.

Changing the financing of Medicare has proved difficult. In 1988, Congress passed legislation to expand Medicare to cover the health care costs associated with catastrophic illnesses. The new coverage was to be financed by a surtax on the incomes of taxpayers over the age of 65. Elderly citizens and organizations such as the American Association of Retired Persons vigorously protested the tax. In the face of this opposition, Congress repealed the law in 1989.

In Fischer v. United States, 529 U.S. 667 S. Ct. 1780, 146 L. Ed. 2d 707 (2000), the U.S. Supreme Court addressed the issue of criminal aspects with respect to payment of Medicare benefits to an institution. Fischer, while president and part owner of Quality Medical Consultants, Inc. (QMC), negotiated a $1.2 million loan to QMC from West Volusia Hospital Authority (WVHA), a municipal agency that is responsible for operating two Florida hospitals, both of which participate in the federal Medicare program. In 1993 WHVA received between $10 and $15 million in Medicare funds. After a 1994 audit of WHVA raised questions about the QMC loan, the petitioner was indicted for violations of the federal Bribery statute, including defrauding an organization that receives benefits under a federal assistance program. A jury convicted him on all counts, and the district court sentenced him to prison, imposed a term of supervised release, and ordered the payment of restitution. On appeal, the petitioner argued that the government had failed to prove WHVA, as the organization affected by his wrongdoing. The U.S. Court of Appeals for the Eleventh Circuit rejected his argument and affirmed his conviction.

In 2003, President George W. Bush and Congress worked together to pass a new law to bring people with Medicare more choices in health care coverage and better health care benefits. The new Medicare Prescription Drug Improvement and Modernization Act of 2003 was passed. This new law preserved and strengthened the Medicare program by adding important new prescription drug and preventive benefits and provides extra help to people with low incomes. Seniors are still able to choose doctors, hospitals, and pharmacies.

If seniors are happy with the Medicare coverage they have, they can keep it exactly the same. Or, if they choose, may enroll in new options. One of the major changes is the Drug Discount Cards which began in 2004. Medicare-Approved Drug Discount Cards will help seniors save on prescription drugs. Medicare will contract with private companies to offer new drug discount cards until a Medicare prescription drug benefit starts in 2006. The cards will save seniors 10–25% on prescription drugs. The enrollment period for the cards is May 2004 through December 31, 2005.

Other highlights of the new law include a Medicare Advantage Plan, new and improved preventive benefits for 2005, prescription drug plans for 2006, and Health Savings Accounts for all Americans, which will work just like an Individual Retirement Account (IRA), whereby Americans will be able to set aside money each year, tax free, in Health Savings Accounts.

For the latest information on Medicare visit the Medicare web site at

Further readings

Channick, Susan Adler. 2003. "The Ongoing Debate Over Medicare: Understanding the Philosophical and Policy Divides." Journal of Health Law 36 (winter): 59-106.

Cross-references

Elder Law; Health Care Law; Health Insurance; Managed Care; Physicians and Surgeons; Senior Citizens.

Medicare


Medicare

A United States government program providing certain kinds of medical care to persons over 65 years of age. Medicare is funded by the federal government and divided into several parts. Medicare Part A is free (or rather paid with taxes) and pays for visits to the hospital, as well as some other costs. Medicare Part B covers doctor visits if the elderly person pays an extra premium, and Medicare Part D pays for prescription drugs in exchange for a premium. Participation in Parts B and D is voluntary, but participation in Part A is automatic. See also: Medicaid, Social Security, Obamacare.

Medicare.

Medicare is a federal government insurance program designed to provide healthcare coverage for people 65 or older, certain disabled people, and people with chronic kidney disease.

Anyone who qualifies for Social Security is automatically eligible for Medicare at 65.

Part A, which covers hospital and certain other costs, is provided when you enroll. You can also sign up for Part B, which covers doctor visits and related costs, and Part D, which covers prescription medicines, at the same time.

You pay a separate premium for both Part B and Part D. The Part B premium is set annually and carries surcharges for people whose incomes are above the annual ceilings. Your Part D premium is determined by the private insurer plan you select. If you postpone applying for Parts B and D and don't have equivalent or better coverage -- called creditable coverage -- from another plan, you face a permanent surcharge when you do enroll.

You may also have a choice between Original Medicare, which is a fee-for-service plan run by the government, or a Medicare Advantage plan if one is available where you live. Medicare Advantage plans are private insurer plans.

See MDCR

MEDICARE


AcronymDefinition
MEDICAREMedical Care

Medicare


Related to Medicare: Medicaid, Medicare and Medicaid
  • noun

Words related to Medicare

noun health care for the aged

Related Words

  • health care
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