Medicare is a federal health insurance program for persons 65 or older and their spouses at 65, or persons of any age with end-stage renal disease (kidney failure), and certain disabled social security and Railroad Retirement beneficiaries who have received disability benefits for at least 24 months.  The original Medicare as "fee-for-service" Plan consists of two parts:

• Hospital Insurance (PART A) provides institutional care, including inpatient hospital care, skilled nursing home care, past hospital home health care, and hospice care.   The Part A program is compulsory and is financed by social security payroll tax deduction (1.45% of the 7.6% FICA Tax) withheld from wages in 2009.



• Medical Insurance (PART B) is a voluntary program of health insurance, which covers doctor services, outpatient hospital care, physical therapy, ambulance, medical equipment and a number of other services not covered by Part A.   It's financed through monthly premium ($105.00 for most in 2010*) paid by those who enrolled and contributions by the federal government. The government's share is approximately 75% of the cost.

Medicare does not cover custodial care or long term nursing home care.   Much of the care provided in a nursing home is care to people with chronic long-term illnesses or disabilities. that care is considered to be custodial and therefore, is not covered by Medicare.

* If your income is above $80,000 (single) or $160,000 (married couple), then your Medicare Part B premium may be higher than $105.00 per month.

Medicare has two parts: Part A ( Hospital Insurance) and Part B (Medical Insurance).
PART A SERVICE	TIME LIMIT	YOU PAY	MEDICARE PAYS
Hospital Stay: Semiprivate room, meals, general nursing, and other hospital services and supplies. This includes care in critical access hospitals and inpatient mental health care. Inpatient mental health coverage in an independent psychiatric facility is limited to 190 days in a lifetime.	First 60 days per Benefit Period -------------------- Next 30 days of confinement -------------------- Additional 60 lifetime reserve days (once used not replaced) -------------------- Beyond 150 days	$1068.00 Maximum -------------------- $267.00 a day -------------------- $534.00 a day -------------------- All Cost	Balance Does not include: First 3 pints of blood, private duty nursing, TV, telephone, or private hospital room, (unless medically necessary). ---------------- Nothing
Skilled Nursing Facility (SNF) Care: Semiprivate room, meals, skilled nursing and rehabilitative service, and other service and supplies (must occur within 30 days of hospital confinement which lasted 3 or more days).	First 20 days per Benefit Period ---------------- Next 80 days of continuous confinement ---------------- Beyond 100 days	Nothing ---------------- $133.50 a day ---------------- All Cost	100% of approved charges ---------------- Balance ---------------- Nothing
Hospice Care: Medical and support services from a Medicare-approved hospice, drugs for symptom control and pain relief, short-term respite care, care in a hospice facility, hospital, or nursing home when necessary, and other services not otherwise covered by Medicare. Home care is also covered.	Two 90 day periods followed by an unlimited 60 day periods	Up to $5 for outpatient prescription drugs and 5% of approved amount for inpatient respite care.	Balance Doctor must certify that you are terminally ill and you elect to reserve these services.
PART B SERVICE	TIME LIMIT	YOU PAY	MEDICARE PAYS
Medical And Other Services: Doctors' services, outpatient medical and surgical services and supplies, diagnostic tests, ambulatory surgery center, facility fees for approved procedures, and durable medical equipment. Also covers second surgical opinions and outpatient physical and occupational therapy including speech-language therapy. -------------------- Outpatient mental health care: -------------------- Outpatient Hospital Services: For the diagnosis or treatment of an illness or injury. -------------------- Clinical Laboratory Services: Blood tests, urinalysis, and more.	No Limit (except one deductible per calendar year) Exclusions: Most prescription drugs and medicines taken at home; long-term nursing home care and custodial care; services not reasonable or medically necessary; routine physical exams, eye exams, glasses, hearing aids, and dental care; routine foot care and orthopedic shoes, except for diabetics; nearly all services outside the U.S.; and most immunizations (pneumococcal vaccine and flu shots are covered).	First $135.00 each calendar year then 20% of approved amount plus any charges above approved amount and costs for the first 3 pints of blood in a calendar year. -------------------- 50% of approved amount -------------------- 20% of approved amount -------------------- Nothing	80% of approved amount with some exceptions (when services are covered with no cost-sharing) -------------------- 50% of approved amount -------------------- 80% of approved amount -------------------- 100% of approved amount
Home Health Care (Part A and B):	TIME LIMIT	YOU PAY	MEDICARE PAYS
Part-time skilled nursing care, physical, occupational, speech-language therapy, home health aid and medical social services. -------------------- Durable Medical Equipment: and medical supplies, and other services.	First 100 visits per spell of illness (must be home confined) -------------------- No Limit	Nothing -------------------- 20% of approved amount	100% of approved amount (Doctor must set-up a plan of treatment) -------------------- 80% of approved amount

Sources: "Medicare & You 2009," Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services, 2002; "Mutual Care®," Mutual of Omaha Insurance Company, 2004.

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