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When was Medicare established?

Just the essentials...
  • Medicare is a government insurance plan established to help those 65 and older with your health care
  • Supplemental insurance through private insurance companies can help during the Medicare “gap period”
  • Shop and compare insurance to get the best deals based on your status

Medicare is a system that was established in 1965 in The United States under the leadership of Lyndon Johnson. He had Congress enact the Medicare Act under Title XVIII of the Social Security Act as a way to provide people over age 65 with health insurance.

It was intended to help people over 65 years of age from having to pay for their health care and attempted to take care of older people regardless of their personal income or medical history.

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Qualifying Factors

Prescription clipboard with stethoscope

There are not many factors that are required to qualify for Medicare. Below are the primary factors required to receive Medicare:

  • Must be age 65 or older
  • Must have worked in a contributing job at least 10 years
  • Qualifying disability

The main reasons individuals qualify for Medicare is that they have reached the age of 65. Additionally, you need to have spent at least 10 years working in a job that contributed to Medicare. Most jobs would contribute to this if you were an employee in any business that reported incomes and processed employee payroll.

The History of Medicare in America

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Harry Truman started the beginning of Medicare, even though Lydon Johnson was credited with implemented it. On November 19, 1945, Truman asked Congress for the creation of a national health insurance fund that would be open to everyone in America.

Truman envisioned a health plan for individuals that would pay for expenses such as:

  • Doctor visits
  • Hospital stays
  • Lab services
  • Dental care
  • Nursing care

Truman tried to pass the Medicare plan while in office, but Congress rejected it. President John F. Kennedy was another warrior for elderly health care when he tried to bring the bill out again and pass the Medicare Act. But it took another 20 years to get it on the floor again under the Johnson term when it was finally passed.

Medicare Today

Medicare continues to help millions of Americans age 65 and older with health care that they might not be able to afford otherwise. By 2015, there were 55.5 million people who receive health coverage through a Medicare program. The amount of benefits paid through Medicare to patients in 2013 was $583 million.

What has pushed Medicare?

Besides the good people who tried to push the Medicare agenda, many demographic factors have helped to push the Medicare agenda. For one thing, Baby Boomers have retired at record rates over the past 20 years, creating more of a need for medical and health care among retirees who qualify for Medicare.

The Congressional Budget Office is projecting increasing need for Medicare spending shortly.

An Attempt to Divert Medicare

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During the Obama administration, there was an attempt to create a whole new system of health care for everyone under the Socialistic Affordable Health Care Act. This system sounded good on the surface but what people didn’t realize is that it was like a huge lease agreement on a car that started low and blew up like a balloon in the last few months of coverage.

There has been a great deal of controversy over the failed Obamacare with the recent revelations that it was going up almost 100 percent or more previous to Obama leaving office.

Many infuriated members of this system started immediately looking for replacement insurance through private insurance carriers.

The Affordable Health Care Act offered a pseudo-relief system for those who were still uninsured and took some of the funding away from Medicare which was becoming more strained with each year.

But the result was disastrous for those who jumped onto the Affordable Health Care Act in an attempt to save on insurance.

Medicare is a solid program and will continue to be there for Americans. The key is to re-budget the money in a smarter fashion so that it will continue to be available to people who deserve it and worked for it.

The Price of Cost-Reduction

The Obama Administration used the Affordable Care Act to get doctors to push certain drugs and medical treatment so that it would save money over the long term under Medicare’s Part B.

But, despite any advantages to the economy overall, it has been the individual who suffered as a result of this so-called “Affordable Health Care Act.”

The Benefits of Private Insurance

The good thing about dealing with private insurers is that you always know what you are getting when you sign up, and there are no surprises that the government can spring on you at the end of a term. Medicare can also work with your private insurance company to make sure that you get your Medicare benefits in correlation with your private plans.

In fact, you are encouraged to sign up for Medicare, even if you have private insurance. You should make Medicare your primary plan if you are 65 years old or older since you are qualified to receive this benefit. But having a private insurance plan will help supplement your coverage, especially when you gall into the gap period.

What is the gap period?

HSA and piggy bank

The gap period (otherwise known as “the donut hole”) is the period that Medicare patients are temporarily without coverage while their insurance does not pay full coverage. This is a difficult time and can hurt people who take multiple medications financially. But that’s where private insurance as well as HSAs (Health Savings Accounts) can help.

The key is to orchestrate a carefully thought-out plan that will protect you from experiencing financial problems during the gap period and having supplemental coverage to kick in where Medicare left off.

What type of private health insurance should I get?

There are several types of major medical health care plans that you can look into when searching for a health care plan.

– Employer-based Group Insurance

If you are still working for an employer, you may be eligible for benefits under your benefits plan at your place of work. Many individual insurance companies work with employers and places of business that offer their insurance as a payroll deduction option through your place of employment.

Check with your employer to find out what companies you can join through your place of work.

Keep in mind, however, that some programs that are tied to your employment may disappear once you leave your job.

Find out if the products that you purchase are portable and if you can take them with you when you leave or retire.

Remember that once you turn 65, you no longer need employment insurance unless you want it as a supplement to Medicare.

As stated before, it is wise to carry an additional supplemental insurance plan that will help you to compensate for the “donut hole” period with your Medicare insurance.

Not Everyone Falls into the Donut Hole

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Keep in mind that not everyone will fall into the “donut hole” with Medicare. This is only applicable to people who spend a specific amount with Medicare for a given year, especially as it pertains to prescription drugs.

This is something you will want to ask your Medicare or insurance agent. See if they can help you find out where you stand and at what point you might fall into this bracket.

Qualified Health Plans

Qualified health care plans are Obamacare plans that can be purchased with a subsidy such as the Health Insurance Marketplace. To qualify for these plans, you must meet the minimal qualifications of The Affordable Care Act and any other requirements that qualify you for this plan.

Remember that if you buy into the qualified health plans, it is just an extension of Obamacare, a plan that, as of this year (2016), it has proven to be limited in its scope, at best with a balloon payment at the end.

Catastrophic Health Plans

Catastrophic health care plans are primarily available to people under the age of 30 and only offer coverage primarily for unforeseen illnesses. It typically has a high-deductible and is intended for younger people who do not have as many health conditions as older people.

It was intended to serve as affordable health insurance for the younger generation who could not afford private health insurance options and who needed to meet the federal mandate of obtaining insurance, to avoid tax penalties.

How to Find the Best Private Insurance Carrier

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The Affordable Health Care Act may have had its advantages at the onset and allowed a way to meet the federal mandate. However, the best idea for individuals, in the long run, is always going to be individual private insurance companies.

Here are some tips on how to find the best private insurance carrier to meet your needs:

  • Assess your health condition Before you look for a private insurance company, you should take a minute to think about your current health condition. Do you have any preexisting condition? Many insurers will not disqualify you for that, but it may cost you more than if you had a clean bill of health.
  • Consider your prescription drug costsDo you take prescription drugs? If you have prescriptions, you will need to find an insurer that offers this as an extra coverage. Prescription drugs costs alone are among the most expensive types of expensive that people experience when it comes to their individual health care.
  • Consider your ageIf you are 65 or older, you will likely qualify for Medicare. Look into this and see what paperwork you have to do to sign up for Medicare if this is the case.
  • Check into Medicare gap coverage If you have Medicare, you will want to prepare for when you fall into the gap period and plan accordingly. Ask your Medicare professionals about this and then talk to your private insurance agent. This is also one of the questions you will want to ask when shopping for insurance. Make sure you know the fine print about how your private insurance will coordinate with Medicare when you are in the donut hole.
  • Think about deductibles – If you opt for a higher deductible, remember that you will pay less per month, but you will have to pay out of your pocket if you get sick or need medical care. If you are under 65, you will be able to use an HSA as a complementary program to supplement your Medicare coverage. Once you are 65, you will no longer be able to use funds from an HSA.

Shop and Compare Insurance Policies

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What is important to you when you consider your health insurance costs?

Whether you are eligible for Medicare or not, you will want to have private insurance to complement and supplement any unforeseen health issues that might come up. Private insurance carriers offer a wide variety of health care benefits no matter what your age.

Ask your representative these important questions as you compare different companies in making the decision on who you will choose for your insurance carrier. Private insurance gives you more choice than government insurance.

Health insurance costs have skyrocketed, but there is hope that this will level out in the future. Private insurance companies are there to offer you clear alternatives to the government-based insurance while supplementing Medicare for those who are 65 or older.

Compare Medicare health insurance plans today so you’re always covered in the future. Use our free tool below to start!

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MedicareInsurance.com is privately owned and operated. MedicareInsurance.com is a non-government asset for people on Medicare, providing resources in easy to understand format. The government Medicare site is www.medicare.gov.

This website and its contents are for informational purposes only and should not be a substitute for experienced medical advice. We recommend consulting with your medical provider regarding diagnosis or treatment, including choices about changes to medication, treatments, diets, daily routines, or exercise.

This communication’s purpose is insurance solicitation. A licensed insurance agent/producer or insurance company will contact you. Medicare Supplement insurance plans are not linked with or sanctioned by the U.S. government or the federal Medicare program.

MULTIPLAN_GHHK5LLEN_Accepted Last Updated 3/18/2018