The Medicare Program
The Original Medicare Program, also known as Fee-For-Service (FFS) Medicare,
consists of:
• Part A, hospital insurance; and
• Part B, medical insurance.
Under FFS Medicare, eligible individuals may enroll in Part A, Part B, or both
Part A and Part B. Most individuals choose to enroll in both Part A and Part B.
FFS Medicare was expanded in 1973 to include:
• Individuals who are under age 65 with certain disabilities; and
• Individuals with End-Stage Renal Disease.
Two parts were added to the Medicare Program in 1997 and 2006, respectively:
• Part C, Medicare Advantage (MA) (first known as Medicare+Choice); and
• Part D, the Prescription Drug Benefit.
MA is another health plan choice available to beneficiaries. It is a program
run by Medicare-approved private insurance companies. Most MA organizations
arrange for or directly provide health care items or services to the
beneficiary who:
• Is entitled to Part A and enrolled in Part B;
• Permanently resides in the service area of the MA Plan; and
• Elects to enroll in a MA Plan.
The Prescription Drug Benefit provides prescription drug coverage to all
beneficiaries enrolled in Part A and/or Part B who elect to enroll in a
Medicare Prescription Drug Plan (PDP) or a MA Prescription Drug Plan. Insurance
companies or other companies approved by Medicare provide prescription drug
coverage to such individuals who live in the Plan’s service area. Medicare
beneficiaries who meet certain income and resource limits may qualify for the
Extra Help Program, which helps pay for PDP costs.
The Medicaid Program
The Medicaid Program is a cooperative venture funded by Federal and State
governments that pays for medical assistance for certain individuals and
families with low incomes and limited resources. Within broad national
guidelines established by Federal statutes, regulations, and policies, each
State:
