Final answer:
Medicare coverage is determined by medical necessity and coverage categories outlined in the policy. It is part of the Social Security Act of 1965 and offers health insurance plans for those 65 and older. Coverage details and policy regulations evolve over time, with considerations for economic factors and healthcare needs.
Step-by-step explanation:
The policy that determines if a particular item or service is covered by Medicare involves various factors, including whether the service is considered medically necessary and falls under the approved coverage categories. Medicare, a significant part of the Social Security Act of 1965, provides health insurance for individuals 65 and older, offering different plans with different levels of coverage. Plan A focuses on hospitalization coverage, while Plan B is more similar to traditional health insurance, covering medical costs outside of the hospital with beneficiaries paying small premiums. This coverage often includes hospital stays, physician fees, and diagnostic services, but beneficiaries must also pay deductibles and copayments.
Moral hazard, adverse selection, and other issues affect how Medicare is administered and what services are covered. Medicare is essential in the ongoing conversation about health policy in the United States, and debates continue over the proper role of government in healthcare and the balance of power between federal and state entities regarding this issue. The coverage provided by Medicare has evolved over time, and adjustments are often made based on changing healthcare needs and economic considerations.