In 2019, beneficiaries have a choice of 27 PDPs and 21 MA-PDs, on average.

Part D covers outpatient prescription drugs through private plans that contract with Medicare, including stand-alone prescription drug plans (PDPs) and Medicare Advantage plans with prescription drug coverage (MA-PDs).

Enrollment in Medicare Advantage plans has grown over time, with more than 20 million beneficiaries enrolled in Medicare Advantage in 2018, or 34 percent of all Medicare beneficiaries (Figure 3).įigure 3: Total Medicare Private Health Plan Enrollment, 1999-2018

Part C refers to the Medicare Advantage program, through which beneficiaries can enroll in a private health plan, such as a health maintenance organization (HMO) or preferred provider organization (PPO), and receive all Medicare-covered Part A and Part B benefits and typically also Part D benefits.

Preventive Services Task Force, such as mammography or prostate cancer screenings. No coinsurance or deductible is charged for an annual wellness visit or for preventive services that are rated ‘A’ or ‘B’ by the U.S. Many Part B benefits are subject to a deductible ($185 in 2019), and, typically, coinsurance of 20 percent.

Part B covers physician visits, outpatient services, preventive services, and some home health visits.

Part A also requires coinsurance for extended inpatient hospital and SNF stays. Part A benefits are subject to a deductible ($1,364 per benefit period in 2019).

Part A covers inpatient hospital stays, skilled nursing facility (SNF) stays, some home health visits, and hospice care.

In 2016, half of all people on Medicare had incomes below $26,200 per person and savings below $74,450.įigure 2: Medicare Benefit Payments by Type of Service in 2017 Nearly two million beneficiaries (3%) lived in a long-term care facility. More than one in seven beneficiaries (15%) were under age 65 and living with a long-term disability, and 12 percent were ages 85 and over.

In 2016, nearly one third (32%) had a functional impairment one quarter (25%) reported being in fair or poor health and more than one in five (22%) had five or more chronic conditions, (Figure 1). Many people on Medicare live with health problems, including multiple chronic conditions and limitations in their activities of daily living, and many beneficiaries live on modest incomes. It covers many basic health services, including hospital stays, physician services, and prescription drugs. #Medicare plays a key role in providing health and financial security to 60 million older people and younger people with disabilities. People under age 65 who receive Social Security Disability Insurance (SSDI) payments generally become eligible for Medicare after a two-year waiting period, while those diagnosed with end-stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS) become eligible for Medicare with no waiting period. Most people ages 65 and over are entitled to Medicare Part A if they or their spouse are eligible for Social Security payments, and do not have to pay a premium for Part A if they paid payroll taxes for 10 or more years. In 2017, Medicare spending accounted for 15 percent of total federal spending and 20 percent of total national health spending. The program helps to pay for many medical care services, including hospitalizations, physician visits, prescription drugs, preventive services, skilled nursing facility and home health care, and hospice care. Today, Medicare plays a key role in providing health and financial security to 60 million older people and younger people with disabilities.

The program was expanded in 1972 to cover certain people under age 65 who have a long-term disability. Medicare is the federal health insurance program created in 1965 for people ages 65 and over, regardless of income, medical history, or health status.

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