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Category:Auditing standardsSocial Security and Medicare Insurance programs (SMI) in the United States provide insurance coverage for health care and long-term care services, which are a necessity for many Americans. These insurance programs have evolved over the past century, however, and continue to evolve today. Within the current health care system, SMI is one of the major components of health insurance coverage, and the American population is familiar with SMI programs. As a part of health insurance, SMI beneficiaries are required to pay premiums for their coverage. While SMI premiums have been increasing in recent years, rising health care costs and the issue of health care coverage for the uninsured have recently lead to a federal government discussion of SMI premiums. In fact, in 2003, the U.S. Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act. This Act included a provision to change Medicare's traditional method of beneficiary cost-sharing for SMI insurance premiums. The provision requires SMI beneficiaries to pay a fixed amount of SMI premiums and thus limits beneficiaries' use of resources for this insurance coverage.
SMI is an independent Medicare benefit. In other words, SMI provides benefits different from Medicare Supplemental Insurance (Medigap), which provides supplemental health insurance to SMI beneficiaries. As SMI is not a traditional insurance product, it differs from traditional health insurance. SMI is defined as a series of separate Medicare insurance plans offered through private health insurance companies. Currently, SMI is offered through some of the larger private health insurance companies, such as Aetna, Blue Cross Blue Shield, Coventry, Humana, UnitedHealthcare, and Wellpoint. SMI may be offered either through an employer plan or independently.
Beneficiaries have the option to choose between having SMI plan premiums paid directly by their employers or having SMI premiums paid directly by the beneficiary. Employers have always paid SMI premiums for their employees. In the early years, the SMI programs were very simple, consisting of just a hospital insurance component. Over time, the SMI program was expanded to include many insurance options, including:
Traditional hospital insurance plans
Medical insurance plans
Life insurance plans
Long-term care insurance plans
Prescription drug coverage plans
These expanded SMI options enabled employers and beneficiaries to use the SMI plans for more than just hospital care and medicine. In fact, in recent years, long-term care and prescription drug coverage has been ac619d1d87
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