History of Medicare

Medicare was established on July 30, 1965, when President Lyndon B. Johnson signed the Social Security Amendments of 1965 into law during a ceremony at the Truman Library in Independence, Missouri. Former President Harry S. Truman, who had long advocated for national health insurance, was issued the first official Medicare card in honor of his efforts. Medicare was created in response to the growing number of elderly Americans who lacked health insurance and struggled with the rising costs of medical care.

Initially, Medicare consisted of two parts: Part A (Hospital Insurance) and Part B (Medical Insurance). Part A was designed to cover inpatient hospital stays and limited skilled nursing and home health care, while Part B helped pay for physician services, outpatient care, and preventive services.

Over the decades, Medicare evolved to meet the changing healthcare needs of its beneficiaries:

In 1972, eligibility was expanded to include individuals under age 65 with long-term disabilities and those with End-Stage Renal Disease (ESRD).

In 1997, the Balanced Budget Act created Medicare+Choice, later renamed Medicare Advantage (Part C), which allowed private insurance companies to offer Medicare benefits.

In 2003, the Medicare Modernization Act introduced Part D, providing prescription drug coverage beginning in 2006.

Today, Medicare remains a cornerstone of healthcare for over 65 million Americans, continuing to adapt through reforms, technology, and policy changes to better serve aging and vulnerable populations.

Medicare is a federal health insurance program in the United States designed primarily for individuals aged 65 and older, although it also provides coverage for certain younger people with disabilities and those with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant). Established in 1965 under the Social Security Act, Medicare helps cover many essential medical services, including hospital care, doctor visits, preventive services, and prescription drugs. The program is divided into four parts: Part A covers inpatient hospital care, skilled nursing facility care, hospice, and some home health services; Part B helps cover outpatient care such as doctor visits, lab tests, and preventive services; Part C, also known as Medicare Advantage, is an alternative way to receive Medicare benefits through private insurance plans approved by Medicare that often include additional services like vision, dental, or hearing coverage; and Part D provides prescription drug coverage through private plans. While Medicare helps reduce healthcare costs, it does not cover all expenses, and many beneficiaries choose to enroll in supplemental insurance plans to help pay for deductibles, copayments, and other out-of-pocket costs.

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Medicare Part A covers hospitalization and inpatient care. It pays for hospital stays, skilled nursing facility or nursing home, hospice care and home health services. Any services provided as in inpatient care would fall under Part A coverage such us physical and occupational therapy, medications, counseling for terminally ill people, and more. Part A doesn't cover 100% of your medical costs. You could still have out-of-pocket costs including copayments, coinsurance, and deductibles. 

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Medicare Part B covers outpatient medical services and preventive services. It pays for all the medical care required to diagnose and treat medical conditions including doctor visits, urgent care, lab work, tests, and medical equipment or devices.

Preventive services refer to medical care received in order to prevent illness, like vaccines, or healthcare services undergone for early detection, like cancer screenings and routine physicals.

Part B also covers ambulance services, outpatient mental health services, durable medical equipment (DME), and prescription drugs given at medical settings

Part B does not cover everything 100%! It has an annual deductible of $266 and 20% coinsurance after meeting the deductibles.

Learn more about Part B
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Part C and Medicare Advantage Plans are interchangeable in their names! Medicare Advantage plans are required by law to cover all services provided under Original Medicare Parts A and B of Medicare. Medicare Advantage plans are run by private insurance companies that contract with the federal government to provide the services. Additionally, those plans may also include prescription drug coverage embedded in them. Part C Medicare Advantage plans offer additional services beyond what Original Medicare offers like dental, vision and hearing services. Part C plans often provide Over-the-Counter benefits and fitness membership.

Medicare Advantage plans have low or $0 monthly premiums. Medicare Advantage plans do not cover all services at 100%. They have a schedule of fees like copayments, deductibles, and coinsurance for different services. For example, you may pay $0 copayment when you visit the primary care physician but you may $50 when you visit a specialist. By law, all plans must have an Maximum-Out-Of-Pocket which sets a dollar limit on how much you can spend on your healthcare.

Learn more about Part C
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Part D provides prescription drug coverage. Part D Prescription Drug Plans (PDPs) are approved my CMS but are only available through private insurance companies. Beneficiaries can enroll in a standalone Prescription Drug Plan (PDP) if they have chosen Original Medicare or they can enroll in a Medicare Advantage Plan (Part C) in which Part D is included. You can join a stand-alone Part D plan if you have either Part A and/or Part B. However, you must be enrolled in both Parts A and B if you would like to join a Medicare Advantage with Prescription Drug (MAPD) plan. Each insurance company provide a list of approved prescription drugs covered under each of their plans. It is important to make sure that your drugs are covered and also pay attention to how much is your out-of-pocket costs.

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Medicare Supplement
versus
Medicare Advantage

Medicare Supplement Planvs.Medicare Advantage Plan
You Pay Medicare Part B Premium. You may have to pay Part A Premium if you don't meet certain criteria. You also pay for the Medicare Supplement plan monthly premiumPremium CostYou continue to Pay Medicare Part B Premium, Part A Premium any, and the monthly Premium of the Medicare Advantage, if any. Whenever you access healthcare services, you are generally required to pay copayments, coinsurance and/or deductibles
Medicare Supplement has No Network. Your may visit any medical facility and provider across the United States that accept MedicareNetworkMedicare Advantage plans have Network of provider that you have to stay within. However, emergency and urgent care visits are always covered when traveling in the United States
You may choose any doctor and hospital that are contracted with Medicare and accepting Medicare patientsDoctors & HospitalsYou may be required to choose from the plan network of
physicians and hospitals
You may use any specialist without a referral from your Primary Care PhysicianSpecialist ReferralsReferrals may be required
before seeing specialists
Prescription drugs coverage is not included. You have to enroll in Part D Prescription Drug Plan with additional monthly premiumPrescription Drug
Coverage 		Most Medicare Advantage Plans include prescription drugs embedded with the plan
You have 6 month of Medicare Supplement Open Enrollment Period starting on your 65th birth-month with guaranteed issue policy. Afterwards, You can enroll or change Medicare Supplement plan any time, but you are subject to medical underwritingEnrollment PeriodsThere are specific periods (IEP, MA OEP, Medicare AEP) during the year to enroll or switch plans. Medicare Advantage has no underwriting
Generally, most Medicare Supplement plans have no Maximum-Out-Of-Pocket with the exception of plans K and LOut-of-Pocket
Maximums		CMS requires all Medicare Advantage plans to have a Maximum-Out-Of-Pocket
Medicare Supplement plans do not have dental, vision, or hearing aid coverage. Some carriers do offer a buy up plan for those benefits with additional premiumVision, Dental, and
Hearing Services		Most Medicare Advantage plans offer Eye exams, eyeglasses and corrective lenses; Dental exams, cleanings and X-rays; Hearing tests and hearing aids
Some Medicare Supplement plans provide additional coverage for medical emergencies while traveling abroadForeign TravelMost Medicare Advantage plans do not provide additional coverage for traveling abroad with the exception of medical emergencies
If you are enrolling during your Medicare Supplement your 6 month Open Enrollment Period, you are guarantee issued coverage with no pre-existing exclusion or waiting period. After this period, you may
need to pass medical underwriting to qualify and a pre-existing waiting period may apply		Pre-existing conditionsYou can enroll in Medicare Advantage plans regardless if you have a Pre-Existing condition
Some Medicare Supplement may offer a fitness membership programAdditional BenefitsSome Medicare Advantage plans offer additional benefits like fitness and wellness programs, transportation services, home modification/
maintenance services, telehealth and social worker teleservices, and more

Original Medicare Path
versus
Medicare Advantage Path

Original Medicare Path

Part A
+
Part B
+
Medicare Supplement
+
stand alone
Prescription Drug Plan		vs.Medicare Advantage Path

Part A
+
Part B
+
Medicare Advantage
+
may include
Prescription Drug Plan
With Original Medicare path, pay higher in premiums, pay little or nothing as you go!Out-of-Pocket CostWith Medicare Advantage path, pay little or nothing in Premiums, pay more as you Go!
You pay monthly premium for the Medicare Supplement plan in addition to Part B premiumPremium CostYou may pay low or no monthly premium for the Medicare Advantage plan in addition to Part B premium
Neither Medicare Part A, Part B, or Medicare Supplement plan cover prescription. You will need to Enroll in a separate Part D Prescription Drug Plan which will have an additional monthly premiumDrug CoverageMost Medicare Advantage Plans include Part D Prescription Drugs Coverage embedded in the plan with no additional premium
Depending on the Medicare Supplement plan you choose, your out-of-pocket may be limited when you get healthcare servicesMedical ExpenseWith Medicare Advantage, when you get healthcare services, you may have to pay deductibles, coinsurance, and fixed copays up to the Maximum-Out-Of-Pocket (MOOP) set be the plan
Depending on the time of enrollment into a Medicare Supplement, you maybe subject to underwriting. Insurance companies my deny you to enroll due to pre-existing conditions or increase your monthly premiumsUnderwriting and EnrollmentMedicare Advantage plans have no underwriting guidelines that will cause you to be denied from joining the plan or increase your monthly premium
Medicare Supplement plans have standardized coverage. Most insurance do not provide additional benefits like Dental, Vision, etcAdditional BenefitsMedicare Supplement may provide additional benefits such as Dental, Vision, Hearing, Gym membership, over-the-counter benefits, etc.
With Medicare Supplement, you can visit any healthcare facility and provider who are contracted with Medicare anywhere in the United States. You don't need a referral to see a specialistNetworkWith Medicare Advantage, you may only visit healthcare facilities and providers who are in the plan network. You may need a referral from your PCP to see a specialist

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