Medicare

(med′ĭ-kar″)

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In the U.S., a federally sponsored health insurance program for people over age 65 who have worked at least 10 years and are U.S. citizens or permanent residents, for some younger disabled people, and for those with end-stage renal disease. Approval for Medicare is managed by the Social Security Administration. The government pays directly for the health care services that a client receives. A client can see any physician who takes Medicare (and most do) anywhere in the country without prior permission and pays a coinsurance for each service received (fee-for-service). There are limits on how much physicians and hospitals are allowed to charge a client. A client can also choose to receive Medicare benefits from a Medicare private health plan, which must offer at least the same benefits as Original Medicare but can also have different rules, costs, and restrictions. A client may be automatically enrolled in a Medicare private health plan if his or her employer sponsors one when the client becomes eligible for Medicare. Website: www.medicare.gov
SEE: Medicaid; SEE: Medicare Advantage plan; SEE: Medigap

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