Medicare Beneficiary | Practical Law

Medicare Beneficiary | Practical Law

Medicare Beneficiary

Medicare Beneficiary

Practical Law Glossary Item w-027-3845 (Approx. 3 pages)

Glossary

Medicare Beneficiary

An individual who is entitled to benefits under Medicare Part A and enrolled under both Medicare Part A and Medicare Part B (known together as Original Medicare) or enrolled only under Medicare Part B. Medicare is the federal health insurance program created for seniors under Title XVIII of the Social Security Act (42 U.S.C. §§ 1395 to 1395lll).
Medicare covers people:
  • Age 65 or older regardless of income, medical history, or health status if they:
    • are US citizens or permanent legal residents that have lived in the country for more than five years; and
    • have enough credits to be eligible for social security or are government employees who have not paid into social security but have paid Medicare payroll taxes.
  • Under age 65 who:
    • are entitled to social security disability benefits for at least 24 months;
    • receive a disability pension from the Railroad Retirement Board;
    • have end-stage renal disease (ESRD); or
    • have amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease).
An individual who is entitled to benefits under Medicare Part A but chooses to enroll in Medicare Part C is known as a Medicare enrollee. For more information on Medicare, see Practice Note, Health Care Payors and Reimbursement: Overview: Medicare.