MEDICARE AND MEDICAID: KEY PUBLIC HEALTH
INSURANCE PROGRAMS OVERVIEW NEWLY
RELEASED THIS YEAR
1. Medicare: A federal insurance program
2. Centers for Medicare & Medicaid Services (CMS): The agency that oversees Medicare
3. Title XVIII of Social Security Act: The legislative framework for Medicare
4. Entitlement program: A program where people contribute through taxes and are entitled to benefits
regardless of income and assets
5. Eligibility for Medicare: Those 65 years old or older, disabled who are entitled to Social Security benefits,
those with end-stage renal disease or ALS
6. SSDI: Social Security Disability Insurance, benefits begin after 24 months
7. Medicare Enrollment: Beneficiaries in Millions from 1966 to 2024
8. Demographic Characteristics of Medicare Population, 2023: Age distribution and
gender breakdown of Medicare beneficiaries
9. Part A: Inpatient Care
10. Part B: Outpatient Care
11. Part C: Medicare Advantage (Managed Care)
12. Part D: Prescription Drug Coverage
13. Medicare Part A Financing: Financed by mandatory payroll taxes, beneficiary deductibles, co-pays
14. Payroll Tax Rate for Medicare: Employer and employee each pay 1.45% payroll tax into the Hospital
Insurance Trust Fund
15. Inpatient Care Coverage: Covers inpatient hospital care, skilled nursing facility, home health, and
hospice
16. Social Security Payroll Taxes: Person (or spouse) must pay at least 40 quarters of Social Security
payroll taxes
17. Medicare Part A Deductible: $1,676 deductible for days 1 - 60
18. Medicare Part A Co-pay: $419 daily co-pay for days 61 - 90
19. Benefit Period for Medicare Part A: Starts at hospitalization and ends after 60 days not in hospital
or SNF
20. Lifetime Reserve Days: 60 additional inpatient days with $838 daily co-pay
21. Medicare Part B: A voluntary program financed by Supplementary Insurance Trust Fund
22. Part B Premiums: Monthly premiums, deductibles, co-insurance (typically 20%)
23. Means Testing in Part B: Premiums based on yearly income (MAGI) with specific thresholds
1/8
,MEDICARE AND MEDICAID: KEY PUBLIC HEALTH
INSURANCE PROGRAMS OVERVIEW NEWLY
RELEASED THIS YEAR
24. Medicare Part C: Created in 1997 as Medicare+Choice, now known as Medicare Advantage
25. Out-of-pocket costs: Capped at $9,350/yr (in-network) & $14,000 (in- and out-of-network combined)
2/8
INSURANCE PROGRAMS OVERVIEW NEWLY
RELEASED THIS YEAR
1. Medicare: A federal insurance program
2. Centers for Medicare & Medicaid Services (CMS): The agency that oversees Medicare
3. Title XVIII of Social Security Act: The legislative framework for Medicare
4. Entitlement program: A program where people contribute through taxes and are entitled to benefits
regardless of income and assets
5. Eligibility for Medicare: Those 65 years old or older, disabled who are entitled to Social Security benefits,
those with end-stage renal disease or ALS
6. SSDI: Social Security Disability Insurance, benefits begin after 24 months
7. Medicare Enrollment: Beneficiaries in Millions from 1966 to 2024
8. Demographic Characteristics of Medicare Population, 2023: Age distribution and
gender breakdown of Medicare beneficiaries
9. Part A: Inpatient Care
10. Part B: Outpatient Care
11. Part C: Medicare Advantage (Managed Care)
12. Part D: Prescription Drug Coverage
13. Medicare Part A Financing: Financed by mandatory payroll taxes, beneficiary deductibles, co-pays
14. Payroll Tax Rate for Medicare: Employer and employee each pay 1.45% payroll tax into the Hospital
Insurance Trust Fund
15. Inpatient Care Coverage: Covers inpatient hospital care, skilled nursing facility, home health, and
hospice
16. Social Security Payroll Taxes: Person (or spouse) must pay at least 40 quarters of Social Security
payroll taxes
17. Medicare Part A Deductible: $1,676 deductible for days 1 - 60
18. Medicare Part A Co-pay: $419 daily co-pay for days 61 - 90
19. Benefit Period for Medicare Part A: Starts at hospitalization and ends after 60 days not in hospital
or SNF
20. Lifetime Reserve Days: 60 additional inpatient days with $838 daily co-pay
21. Medicare Part B: A voluntary program financed by Supplementary Insurance Trust Fund
22. Part B Premiums: Monthly premiums, deductibles, co-insurance (typically 20%)
23. Means Testing in Part B: Premiums based on yearly income (MAGI) with specific thresholds
1/8
,MEDICARE AND MEDICAID: KEY PUBLIC HEALTH
INSURANCE PROGRAMS OVERVIEW NEWLY
RELEASED THIS YEAR
24. Medicare Part C: Created in 1997 as Medicare+Choice, now known as Medicare Advantage
25. Out-of-pocket costs: Capped at $9,350/yr (in-network) & $14,000 (in- and out-of-network combined)
2/8
