Medicare is a government program that provides health insurance in the United States for people who are 65years and above and younger people with disabilities as determined by the social security administration. Medicare is under social security administration and it is being provided by the centers for Medicaid and Medicare Services ( Maisler, 2017). According to the 2019 report of Medicare trustees, Medicare has been able to provide health coverage to over 59.9 million people with 52 million being 65 years and above. It covers almost half of hospital bills for those who are enrolled ( Trustees Report & Trust Funds , 2019) . The paper analyzes the historical development of Medicare and the key considerations.
The president Lyndon B Johnson signed a bill in 1965 which led to the emergence of Medicare. It took effect in 1966 and the former president Harry Truman was the first beneficiary of Medicare. Harry Truman had proposed a national health insurance program but it was opposed by Congress and he was being honored with the first Medicare card. This was the time when older people above 65 could not get private insurance coverage. Meeting the need for medical service for the elderly was one of the priorities of President Lyndon B Johnson’s administration ( Cosgrove, 2010).
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The economic reason that encouraged the implementation of Medicare was that health costs increased during old age and also that is the time when income starts declining and one could not afford private insurance since it was expensive. Before Medicare was established there was government medical assistance for the aged, however, it was limited in terms of who was eligible and the scope of coverage. Because of this restriction, only those with serious conditions were helped ( Cosgrove, 2010).
Medicare contains four parts, part A which provides hospital insurance for inpatients and home healthcare. Part B covers outpatient services. Part D covers the drug prescription and it is not directly provided by the government and finally, part C which is the managed Medicare which gives an option to the patients to choose with the same coverage as part A and B. Part C entails coverage offered by private companies and includes extra benefits such as dental, vision and hearing coverage. It is mandatory for a person to enroll in part A and B before enrolling in part C ( Maisler, 2017).
The initial Medicare program contained two parts, Part A which is the hospital insurance and part B which is the medical insurance. There have been changes made to Medicare by congress and today the two parts are referred to as Original Medicare ( Maisler, 2017). The eligibility of the program was extended in order to cover Americans who were under 65 years of age but with disabilities and also for all people with permanent kidney problems which required transplant or dialysis irrespective of age in 1972 by President Richard M Nixon ( Edwards, 2014).
In 1980 Medicare supplement was developed which allowed the recipients of Medicare to have extra health coverage from a private insurer in order to cover the costs that were originally not covered by Medicare. In 1987 Medicare patient and program protection Act was established. According to the Act, the provision of false medical information is considered a felony ( Cosgrove, 2010) . In 2003 the president at that time George W Bush signed into the law the Medicare Modernization Act (MMA). The objective of the Act was to add outpatient prescription drug benefits to Medicare which is Medicare part D ( Maisler, 2017).
Some of the key considerations when enrolling in Medicare include the following. First is that Medicare is per individual as compared to employee medical plans which cover for the employee, spouse and even children. Each person eligible to Medicare in family is required to have their own Medicare and if they do not qualify one has to find separate health coverage ( Edwards, 2014).
Secondly is that one should understand the advantages and disadvantages of each coverage. One should consider whether the medical plan option will deliver. One can choose original Medicare, part C or part D depending on one’s circumstances. Thirdly is that one should consider the cost of the Medicare plan chosen. Some of the costs are yearly deductible, monthly premium and sometimes in case of late enrolment penalties. Finally is that one should consider whether the chosen plan is convenient. Some healthcare institutions do not accept new patients enrolled in the Medicare advantage plan ( Edwards, 2014) .
In conclusion, Medicare still covers the old in the United States and remains the primary social insurance program for the elderly, young people with disabilities and for all people with permanent kidney problems which requires transplant or dialysis irrespective of age. Medicare contains four parts, part A which gives inpatient coverage, part B which covers outpatient, part C covers alternative way of receiving Medicare services and part D which covers drug prescription. Before Medicare enrolment, one should consider many things, for example, the type of Medicare plan to enroll in, the cost of the chosen plan and the convenience of the plan.
References
Cosgrove, J. C. (2010). Medicare Managed Care: Observations about Medicare Cost Plans . DIANE Publishing.
Edwards, K. A. (2014). Who Needs Medicare? Health Insurance Sources for Disability Insurance Recipients Before and after Medicare Eligibility. SSRN Electronic Journal . https://doi.org/10.2139/ssrn.2687185
Maisler, R. (2017). Centers for Medicare and Medicaid Services proposes new telehealth services for Medicare beneficiaries. Alzheimer's & Dementia , 13 (10), 1179-1180. https://doi.org/10.1016/j.jalz.2017.09.002
Trustees Report & Trust Funds . (2019, November 29). CMS Homepage | CMS. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/ReportsTrustFunds
