Medicare とは？③

What about services that are not provided through Medicare?
Supplemental coverage for medical expenses and services that are not covered by Medicare are offered through MediGap plans. MediGap consists of 12 plans that the Centers for Medicare and Medicaid Services have authorized private companies to sell and administer. Since the availability of Medicare Part D, MediGap plans are no longer able to include drug coverage.
メディケアで支払われない補完的なサービスはメディギャップを通じて支払われる。メディギャップは認可された企業が販売・運営する12のプランからなる。メディケアDができたので薬剤は対象外。


Who is eligible for Medicare
To be eligible for Medicare, an individual must either be at least 65 years old, under 65 and disabled, or any age with End-Stage Renal Disease (permanent kidney failure that requires dialysis or a transplant.)
メディケアの対象者は65歳以上、または65未満の障害者および透析が必要な末期肝臓病患者。

In addition, eligibility for Medicare requires that an individual is a U.S. citizen or permanent legal resident for 5 continuous years and is eligible for Social Security benefits with at least ten years of payments contributed into the system.
さらに、アメリカ市民で、5年連続で米国に居住し、10年以上社会保険料を支払っている必要がある。


Who pays for services provided by Medicare?
Payroll taxes collected through FICA (Federal Insurance Contributions Act) and Self-Employment Contribution Act are a primary component of Medicare funding. The tax is 2.9% of wages, usually half paid by the employee and half paid by the employer. Moneys are set aside in a trust fund that the government uses to reimburse doctors, hospitals, and private insurance companies. Additional funding for Medicare services comes from premiums, deductibles, coinsurance, and copays.
給与税と自営業者拠出がメディケアの主な財源。給与の2.9％が税率で、通常は企業と従業員が折半して支払う。政府が医師、病院、民間保険会社に返金するための基金の積み立てる。その他に、保険料、控除免責金、共同保険、患者負担金なども財源となる。



http://www.medicalnewstoday.com/info/medicare-medicaid/