Medicare is considered to be a part of the Social Security program. For many decades, the United States government tried to come up with a suitable health insurance plan for seniors. A number of national health insurance plans, financed by payroll taxes, were proposed in Congress beginning back in the 1940s. However, none of these were ever brought to a vote at that time.

Following a long national debate, however, the U.S. Congress finally passed legislation in 1965 that established the Medicare program as Title XVlll of the Social Security Act. These 1965 amendments to the Social Security Act established two separate – but coordinated – health insurance plans for individuals who were age 65 and older.

These included a compulsory Hospital Insurance (HI) program, which was considered Part A of Medicare, and a voluntary program of Supplementary Medical Insurance (SMI) which was Medicare Part B.

Individuals are eligible for Medicare Part A (Hospital Insurance) when they reach age 65, provided that they are eligible for monthly Social Security benefits. Those who are covered by the Railroad Retirement system can also participate in Medicare Part A on the same basis as those who are under the Social Security system.

Also eligible are those who would receive a monthly Social Security benefit if their governmental employment were covered work under Social Security. Those persons who are under age 65 and who meet certain disability qualifications are also eligible for Medicare Part A coverage if they have been entitled to Social Security disability benefits for more than 24 months, or if they would be entitled to such benefits if their government employment were covered work under the Social Security Act.

In addition, those of any age who suffer from end stage renal disease (kidney failure) and who meet the special insured status requirements under Social Security are also eligible for Medicare Part A benefits.

Medicare Part B benefits are available to nearly all resident citizens, as well as certain aliens, who are age 65 and over, as well as to disabled beneficiaries who are entitled to Medicare Part A. Part B coverage is optional and must be paid for via a monthly premium, which is typically deducted from the enrollee’s Social Security benefit or Railroad Retirement benefit.

Those who withdraw from the Medicare Part B program before their coverage starts will incur no premium liability. However, the premium rate will be increased by 10 percent for each full year out of the program for persons who do not enroll as soon as they are eligible.

Special waivers of the premium surcharge may be available to individuals and / or their spouses if they are continuing their health care coverage via an employer sponsored health insurance plan or other type of creditable health insurance coverage option.