Generally, one is eligible for Medicare if they or their spouse "worked for at least 10 years in Medicare-covered employment" and if the individual is at least 65 years of age or order and is a permanent resident of the United States. IV. Medicare Premiums

One qualifies for Medicare Part a at age 65 without the requirement of paying premiums if: (1) They already get retirements benefits from Social Security of the Railroad Retirement Board; (2) They are eligible to get Social Security or Railroad benefits but haven't yet filed for them; or (3) They or their spouse had Medicare-covered government employment.

If the individual is under the age of 65 they can receive Part a without the requirement of paying premiums if they have: (1) Received Social Security or Railroad Retirement Board disability benefits for 24 months; or (2) End-Stage Renal Disease and meet certain requirements. (HHS.gov, 2009)

Premiums for Medicare are stated as follows:

Part a: (Hospital Insurance) Premium - Most people get Part a automatically when they turn age 65. They don't have to pay a monthly payment called a premium for Part a because they or a spouse paid Medicare taxes while they were working. You pay up to $443.00 each month if you don't get premium-free. The Part a premium is $244.00 for those individuals having 30-39 quarters of Medicare covered employment.

Part B: (Medical Insurance) Premium - $96.40 per month.

Part a: (Hospital Insurance) Deductible - $1,068.00 (Per Benefit Period)

Coinsurance - $267.00 a day for the 61st - 90th day each benefit period. $534.00 a day for the 91st - 150th day for each lifetime reserve day (total of 60 lifetime reserve days - non-renewable). All costs for each day beyond 150 days.

Skilled Nursing Facility Coinsurance - Up to $133.50 a day for the 21st - 100th day each benefit period.

Part B: (Medical Insurance) Deductible -...

(Note: You pay 20% of the Medicare approved amount for services after you meet the $135.00 deductible.)
V. Suggested Reforms to Medicare -- Georgetown University (2007)

Georgetown University states that Medicare could be "modified to play a larger role in financing long-term care." (2007) According to Georgetown University (2007) "Federalizing long-term care costs for dual eligibles" is one option for expanding the role of Medicare and as well would serve to relieve the state's burdens. This would result in the federal government paying the "full costs of Medicaid long-term care services for Medicare beneficiaries." (Georgetown University 2007) Additionally stated is that long-term care assistance "would remain means tested, but the federal government would pay the full cost rather than the current federal matching rate (which varies across states from 50% to 77%). Along with full federal financing, uniform eligibility and coverage rules would eliminate much of the variation in access to services that characterizes Medicaid today." (Georgetown University, 2007) the second option would be the addition of a personal care benefit to Medicare." (Georgetown University, 2007)

Bibliography

Long-Term Care (2009) Medicare. Online HHS.gov available at: http://www.medicare.gov/LongTermCare/static/Home.asp

Medicare and Long-Term Care (2007) Long-Term Care Financing Project. Georgetown University. February 2007. Online available at: http://ltc.georgetown.edu/pdfs/medicare0207.pdf

Medicare Premiums for 2009 (2009) Medicare Eligibility Tool. HHS.gov. Online available at: http://www.medicare.gov/MedicareEligibility/Home.asp?dest=NAV|Home|GeneralEnrollment|PremiumCostInfo#TabTop

Medicare Eligibility Tool (2009) Medicare -- HHS.gov online available at: http://www.medicare.gov/MedicareEligibility/home.asp?version=default&browser=IE%7C7%7CWindows+Vista&language=English