Conversations about establishing a national health insurance system for protecting the health of Americans began taking place in the early 20th century. In fact, Teddy Roosevelt’s platform included health insurance when he ran for President in 1912. However, a real push for a national health insurance system didn’t begin to gain real momentum until Harry S. Truman became President in 1945. President Truman proposed a national health care insurance fund for all Americans, no matter what their age. The fund was to cover expenses for doctor visits, hospitalization, lab tests, dental services and nursing care. Truman fought valiantly to get legislation passed for his health insurance fund while he was in office, but to no avail.
It would take 20 more years and another failed attempt, this time by President Kennedy, before a bill was championed by President Lyndon B. Johnson and passed by Congress in 1965. This national health plan was called Medicare, and was reserved for Americans 65 years of age and older.*
President Lyndon B. Johnson bestowed the honor of being the very first Medicare beneficiary and receiving the first Medicare card to former President Harry S. Truman for all the efforts during Truman’s Presidency to get a national health care plan passed.
Medicare is available to U.S. Citizens or permanent legal residents (for at least 5 continuous years) who are 65 or older and eligible for Social Security, under 65 and receive Social Security Disability Insurance (SSDI) for a certain period of time, or under 65 and have End-Stage Renal Disease (ESRD) or ALS.
Though seemingly confusing to some at first glance, Medicare is very easy to understand once you have the facts in front of you. Medicare consists of 4 distinct divisions. Medicare Part A, Medicare Part B, Medicare Part C and Medicare Part D.
Medicare Parts A and B are the Original Medicare divisions.
Medicare Part C is essentially the same as Medicare Parts A and B except that Medicare Part C coverage is optional and provided by private insurance companies that can give more flexibility and different options compared to Medicare Parts A and B. This includes access to HMO’s and PPO’s.
Medicare Part D is simply an optional, private, outpatient prescription drug coverage division to help with keeping prescription drug costs lower.
Each Medicare division and primary benefits are listed below.
Medicare Part A (Hospital Insurance – Original Medicare)
Hospital Care (Inpatient)
Skilled Nursing Facility Care
Nursing Home Care
Home Health Services
Medicare Part B (Medical Insurance – Original Medicare)
Medically Necessary Services
Laboratory Tests (including x-rays)
Hospital Outpatient Services
Durable Medical Equipment
Second Opinion before Surgery
Limited Outpatient Prescription Drugs
Services Not Covered by Part A
Medicare Part C (Medicare Advantage Plans)
NOT A SEPARATE BENEFIT (Private Insurance company coverage versus Medicare Parts A & B)
Private Health Plans (HMO’s, PPO’s)
Custom Cost Structure
Typically Includes Part D Prescription Coverage as well
Medicare Part D (Outpatient Prescription Drug Insurance)
Provided through private insurance companies that have contracts with the Government
Never Provided directly from the Government
Must choose Part D that works with other Medicare health benefits
Medicare is a very beneficial government program. It provides hospital, medical and prescription drug care to 50 million Americans. To find out additional information about Medicare, Medicare Supplemental, Medicare Advantage and Medicare Part D options, plans and how to sign up for coverage, please click Here or visit www.agcapitalinsurance.com
*In 1972, legislation expanded coverage to include individuals under the age of 65 with long-term disabilities and individuals with end-stage renal disease. ALS diagnosed patients are also covered no matter their age.