Annie D, no argument with your legal definitions in very general terms. Medicare, generally, yes, there are qualifications. However, users must pay MONTHLY premiums, typically taken out automatically from monthly SSA payments. Savy users can purchase "Medicare Supplement Covaerge" which covers the 20% of medical bills NOT covered by Medicare. In other words, your "Co-pay" is covered by supplemental insurance, Yes, you guessed it, policyholders must pay a premium ($) for "Supplemental Medicare insurance. Yup, you guessed it again, my Supplemental Medicare policy is purchased through a profeessional organization, in my case the ABA, which even pays for my Medicare premiums. NO paper work either. After Medicare pays its 80% for 'seeing' my retinanologist 👀 next week (no pun intended), Medicare automatically, digitally of course, sends the data to the Supplemental insurance carrier. That's the part the medical office personnel love as they do not have to do any work to get their Employer paid promptly. OH yes, I get an automatic Quartely Accounting from the Supplemental carrier for my records and tax purposes. No more stacks of medical billing stuff. :) Finally, recent Biden already-signed-into-law has put a cash limit on the out pocket medication costs as the Middle Class, especially professionals, have overpaid for Decades. Hopefully, we are headed for the New Deal. 2.0.