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| Medicare Quick Facts - Medicare is the federal health insurance program that covers over 35 million Americans ages 65 and older and nearly 6 million younger adults with permanent disabilities.
- Medicare is administered by the Centers for Medicare & Medicaid Services (CMS). However, the Social Security Administration provides information about eligibility, enrollment, and premium obligations.
- Medicare provides broad coverage of basic benefits. Medicare Part A covers inpatient hospital services, skilled nursing facility (SNF) benefits, and hospice care. Part B covers physician and outpatient hospital services, annual mammography and other cancer screenings, and services such as laboratory procedures and medical equipment. Both Part A and Part B cover some home health visits, subject to certain requirements.
- Medicare generally does not cover outpatient prescription drugs or long-term care and has high cost-sharing requirements. As a result, 87% of beneficiaries have some form of supplemental insurance, including employer-sponsored benefits, Medigap policies, Medicare+Choice, and Medicaid, the major public financing program for low-income Americans.
- Forty percent of Medicare beneficiaries have incomes below 200% of the federal poverty level (reflects family income as defined by Census).
- Forty percent of all people on Medicare have less than $12,000 in countable assets.
- The elderly spent on average $3,757 - an estimated 22% of their income - for health care services and premiums in 2002.
- Most people on Medicare - about 3 in 5 - have access to a Medicare HMO or other Medicare+Choice plan in their area. Still, the majority of those on Medicare (89%) are covered under the traditional, fee-for-service program.
- Almost 4 in 10 beneficiaries (38%) lacked drug coverage in the fall of 1999. A quarter of all beneficiaries (25%) lacked drug coverage throughout the entire year. Retiree health benefits are currently the primary source of drug coverage, followed by Medicare HMOs.
- Prescription drug costs are rising rapidly, with average annual out-of-pocket drug costs among the elderly increasing from $644 to $996 between 2000 and 2003.
- Medicare benefit payments are projected to be $269 billion in 2003, accounting for 13% of the federal budget and 19% of total national spending for personal health services.
- Medicare's financial outlook has improved substantially in recent years as a result of changes that slowed the growth in program spending and generated savings to the program. The program is projected to be solvent through 2030, as of the April 2002 Medicare Trustees' Report.
- Over the 2001-2002 period, Medicare spending per capita increased at an average annual rate of 5.2%, compared to increases of 12.7% for premiums in employer plans and 13.0% for premiums in the Federal Employees Health Benefits Program (FEHBP).
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