Medicare Health Insurance for Older Americans Medicare is the U.S. government’s health insurance program for citizens age 65 and older, as well as some younger individuals with specific disabilities and illnesses, and families of deceased workers. Generally, to be eligible for Medicare, you need to be age 65 and you (and/or your spouse) must have paid Medicare and Social Security payroll taxes for at least 10 years. The cost for Medicare will depend on your income, the options you choose, and the medical care you need. There are two ways to receive Medicare coverage: Original Medicare or Medicare Advantage. Original Medicare is divided into two parts: Parts A and B. Participants also have the option of purchasing Part D prescription drug coverage as well as Medicare Supplement Insurance (Medigap), which helps fill in coverage gaps. Medicare Advantage (Part C) plans combine Parts A and B, offer other benefits, and often include prescription drug coverage. • Parts A and B are administered by the federal government. • Parts C and D and Medigap are offered by private, Medicare-approved insurance companies. Because Medicare covers a limited amount of skilled nursing facility care (after a three-day hospital stay), there is a common misconception that Medicare will pay for long-term care. However, all costs for long-term care — assisted living, nursing home care, personal assistance at home —must be paid for out of pocket.
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