Medicare (Health Insurance for the Aged and Disabled)

Title XVIII of the Social Security Act authorizes health insurance benefits for eligible persons who are elderly (65 and older) or disabled. Direct payments are made for medical services on behalf of eligible participants, and the local administration is carried out by fiscal intermediaries (usually private health insurance companies).

Basic eligibility extends to persons age 65 and over who qualify for Social Security benefits. Persons with disabilities who meet the criteria below and meet other statutory tests of eligibility after a 24-month waiting period are also eligible:

  • Disabled workers who met Social Security contribution requirements and are no longer able to engage in substantial gainful activity
  • Persons severely disabled during childhood who are dependents of Social Security beneficiaries that have died, retired, or are themselves eligible for disability benefits
  • Disabled widows and widowers aged 50 and older
  • Any individual suffering from end-stage renal (kidney) disease

Title XVIII has three parts:

  • Part A. Authorizes hospital insurance benefits.
  • Part B. Provides supplemental medical insurance benefits.
  • Part C. Contains miscellaneous provisions.

The major Medicare programs affecting people with disabilities are

 


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