Medicare at a glance

 

Medicare is a federal program that provides health insurance to 44 million people -- about one in seven Americans.

People aged 65 and older are automatically entitled to Medicare if they or their spouse are eligible for Social Security. This group accounts for about 37 million Medicare beneficiaries.

People younger than 65 can qualify for Medicare if the Social Security Administration determines they are disabled. This group comprises about 7 million Medicare beneficiaries.

Among those eligible for Medicare disability coverage are people with HIV or AIDS. They represent about 100,000 Medicare beneficiaries nationwide, including about 8,000 in South Florida.

MEDICARE IS COMPRISED OF FOUR PARTS

Part A, hospital services

Part B, outpatient care

Part C, managed care

Part D, prescription drugs

FRAUD PLAGUES PART B

In urban areas such as South Florida, fraud has plagued Part B, which makes up about 40 percent of Medicare's $432 billion annual budget. It covers claims submitted for outpatient care by physicians, health clinics, medical equipment suppliers and others.

Read more South Florida's Medicare Racket stories from the Miami Herald

  • MIAMI HERALD INVESTIGATION

    Congress tight with Medicare anti-fraud funds

    Congress for years has turned a deaf ear to requests by the Medicare agency for money to fight fraud, which a Miami Herald investigation has identified as a threat to the federal health insurance program for the elderly and disabled.

  • ANTI-FRAUD EFFORTS

    Medicare agency stymied in quest for 'a pound of cure'

    The federal Medicare agency spends less than two-tenths of a cent of every dollar in its budget to fight abuse, waste and fraud.

  • Medicare fraud fugitives evade capture

    The Benitez brothers were masters of Medicare fraud, prosecutors say. They spent their Medicare millions on Mediterranean-style homes, apartments, hotels, boats, a helicopter, even a water park -- all in the resort area of Bavaro, Dominican Republic, court records show.

Miami Herald

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