Medicare health plans are social insurance programs sponsored by the US government to provide health insurance coverage for people aged 65 and up or who meet the special criteria set forth by Medicare health plans. This program funds residency training for a majority of doctors in the US. Medicare is a single payer medical care system. The 1965 Social Security Act was enacted on July 30 by former president Lyndon Johnson. This act was actually an amendment to the standing Social Security legislation at the time.
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The first Medicare health plans were awarded to ex President Harry Truman and his spouse Bess. Medicare health plans are administered by CMS or the Ctrs for Medicare & Medicaid Services which is a part of HHS or the Dept of Health & Human Resources. They also administer Medicaid, SCHIP or the State Children’s Health Insurance Program and the CLIA or Clinical Lab Improvement Amendments. Along with the Depts. of Labor & Treasury, CMS also administers HIPAA or Health Insurance Portability & Accountability Act.
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CMS’ Chief Actuary is responsible for giving cost projections and accounting information to the Medicare health plans’ Board of Trustees who then uses this information to assess the program’s financial health. This board is obligated by law to give annual reports of Medicare’s financial status. These reports are then required to have a statement by the Chief about actuarial opinion. Since Medicare’s beginning, CMS has teamed up with private companies in order to operate as middle men between medical providers and the government.
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These contractors are normally in the insurance area. Contracted processes typically include payment processing and claims, clinician employment, fraud investigation and call center services. Medicare is financed partially by payroll taxes levied by the FICA or Fed Insurance Contributions Act and the 1954 Self Employ Contributions Act. Employees pay a 2.9% tax of their salaries, wages and other forms of compensation; same as with self employed individuals, though half of theirs is deductible. All persons 65 and above who are legal US residents for 5 years at least are then eligible for Medicare. They must however pay a monthly fee or premium in order to be enrolled if neither their spouse nor they have paid taxes for 10 years at least.
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