Medicare is a landmark social program that now covers over 60.6 million Americans.
Pres. Teddy Roosevelt, was the pioneer of a national health insurance program and it was part of his platform in 1912.
President Harry S Truman, called for the creation of a national health insurance fund in 1945 and the original platform for Medicare for All. It wasn’t until 1965 that President Lyndon B Johnson signed Medicare into law for Americans 65 and older rather than earlier proposals.
President Truman and his wife, Bess were the first recipients of a Medicare Card in 1966.
Americans 65 and older were enrolled in Medicare Part A and then millions of seniors signed up for Medicare Part B. 19 million Americans signed up for Medicare during the first year. Medicare still follows this method today. Upon turning 65 you are enrolled in Medicare Part A and then must elect/sign up for Medicare Part B.
In 1988 Congress passed the Medicare Catastrophic Coverage Act, but it was repealed later that year and today, Medicare does not have a cap or limit on OOP – Out of Pocket coverage.
The Medigap or Medicare Supplement insurance was created in the 80’s under Federal oversight.
Medicaid was implemented as a State managed program under Federal Mandate in the 80’s as well.
Medicare Advantage or Medicare Part C did not come to fruition until the 1990’s. Originally HMO plans made available on the private market. The Affordable Care Act required more accountability from these plans, establishing the Star Rating System as a measure of performance.
President Bush signed into law Medicare Prescription Drug Improvement and Modernization in 2003 better known as Part D. These stand-alone plans were first available in 2006.
When Medicare Part B was introduced, enrollee’s monthly premiums were set at $3.00. By early the 2000’s Part B was $50.00 per month. Today, the premium is $144.60.
Approximately 10,000 people turn 65 every day, and Medicare is continually evaluated for our aging market.
Medicare spending is expected to account for 18% of total Federal spending by 2028, which is not that far away. Medicare per-capita spending grew at a slower pace between 2010 and 2017.
INSURANCE POLICY ISSUED BY AN INSURANCE COMPANY. MED SUPPS ARE GUARANTEED RENEWABLE FOR LIFE AS LONG AS PREMIUMS ARE PAID ON TIME. COVERAGE REMAINS IN FORCE FROM YEAR TO YEAR WITH NO OBLIGATION BY THE POLICY HOLDER TO RENEW OR CHANGE
MEDICARE SUPPLEMENT PLANS ARE STANDARDIZED BY THE GOVERNMENT. THEY PROVIDE STABLE COVERAGE YEAR TO YEAR THAT DOES NOT CHANGE. CARRIERS CANNOT CHANGE THE BENEFITS OF A MEDICARE SUPPLEMENT. MEDICARE SUPPLEMENT PLANS ALLOW THE POLICY HOLDER TO SEEK CARE FROM ANY PHYSICIAN OR FACILTY THAT ACCEPTS MEDICARE IN THE COUNTRY.
MEDICRE ADVANTAGE PLANS
MEDICARE ADVANTAGE PLANS ARE ALSO REFERRED TO A MEDICARE PART C. MEDICARE ADVANTAGE PLANS ARE OFFERED BY PRIVATE COMPANIES APPROVED BY MEDICARE. IF YOU JOIN A MEDICARE ADVANTAGE PLAN AS A MEMBER YOU STILL HAVE MEDICARE. SOME NETWORKS ARE NATIONWIDE AND SOME NETWORKS HAVE LIMITED SERVICE AREAS.
MEDICARE ADVANTAGE PLANS REQUIRE MEMBERS TO SEEK CARE FROM A NETWORK AND MAY OFFER OUT OF NETWORK BENEFITS. MEDICARE ADVANTAGE PLANS WILL ALSO INCLUDE PRESCRIPTION DRUG COVERAGE AND HAVE DRUG FORMULARIES UNIQUE TO EACH PLAN. THESE PLANS MAY ALSO OFFER ADDITIONAL BENEFITS SUCH AS DENTAL, VISION AND FITNESS MEMEBRSHIPS LIKE SILVER AND FIT OR SILVER SNEAKERS.
PRESRIPTION DRUG PLANS
PRESCRIPTION DRUG PLANS ARE STAND ALONE PLANS PURCHASED FROM PRIVATE INSURANCE COMPANIES. DRUG FORMULARIES ARE UNIQUE TO EACH PLAN, THERE IS USUALLY AN INITIAL DEDUCTIBLE AND MEDICATIONS WILL BE CLASSIFIED ACCORING TO TIERS 1-5. INSURANCE COMPANIES WILL OFFER STANDARD AND PREFERRED PRICING BASED UPON THE CONTRACT WITH EACH PHARMACY. PREFERRED PRICING AND 90 SUPPLY OFFERINGS ARE USUALLY THE MOST COST EFFECTIVE.
INDIVIDUAL & FAMILY PLANS
Still looking for 2020 coverage? Open Enrollment is over but you may be eligible for special enrollment periods. Contact us for a review to determine if you qualify for special enrollment.
Open Enrollment is November 1, 2020 - December 15, 2020. Use the HealthCare.gov link below to shop for affordable Individual & Family health care plans. Need help selecting the best plan for you or your family? Contact us.