The federal social insurance program dubbed Medicare began operating in 1965. Medicare enrollees are eligible due to their age (65 years and above), while younger people access the insurance due to disabilities or End-Stage Renal Disease (ESRD).
Unlike other programs, government-sponsored health insurance is not restricted to people of a certain state of poverty or lower incomes like Medicaid. But it’s designed to help Medicare-eligible access healthcare services in the United States at a reduced cost.
The statistics indicate that up to 64.2 million Americans were enrolled in Medicare as of 2021. More than 85.8 million are enrolled in CHIP and Medicaid, while 11.8 million are eligible for Medicare and Medicaid.
There are many changes in the healthcare industry and Medicare coverage too. As a result, the national health beneficiaries must be ready to adopt them, including more home care, virtual care delivery, and value-based care models.
Here are the surprising changes that Medicare beneficiaries can expect in the future.
What Does Medicare Contain?
Medicare has different parts, including:
- Medicare Part A
This insurance covers inpatient hospital stays, hospice care, nursing facility care, and home health care.
- Medicare Part B
This Medical insurance covers outpatient care, certain doctors’ and preventative services, and medical supplies.
- Medical Part D
This coverage covers prescription drug costs and recommended vaccines or recommended shots.
- Medicare Advantage
The Medicare-approved plan is an alternative to the original Medicare, allowing seniors to benefit from a private insurance provider. It has parts A, B, and D, as well as extra benefits, including dental, hearing, and vision services.
Many people enrolled in Medicare are concerned about the future of this health insurance.
Here are reasons you should enroll in the best advantage plan Medicare offers.
Wider Medicare Coverage
Over 51% of the 2021 enrollment involved Medicare Advantage, while others enrolled in Medicare cost plan coverage. That shows medical works; thanks to it, millions of American seniors and younger citizens with disabilities can now receive coverage. It’s expected that Medicare will continue to cover many more people in the future.
Initially, in 2020, over 4.6 million were in the original Medicare due to age, Social Security Administration-approved disability, or End-Stage Renal Disease (ESRD). Out of these, approximately 48% or 2.2 million were enrolled in Medicare Advantage plans.
Indeed, many people in different states are taking steps to enroll and stay insured. Those within Florida are benefitting from the reliable Medicare Advantage plans in Florida. Many are taking advantage of the Initial Enrollment Period (IEP). This is the period when Floridians are considered Medicare-eligible for the first time, hence they can enroll.
The period starts three months before you hit your 65th birthday, including your birthday month. It ends three months post your 65th birthday. So, your Initial Enrollment Period will last a sum of seven months. This forms part of the wider Medicare coverage.
Lower Health Insurance Premiums
Although most Medicare enrollees are eligible for premium-free part A, they pay out-of-pocket for part B. The creation of the Affordable Care Act (ACA) marketplaces in addition to premium tax credits in 2014, has ensured affordable, quality health insurance coverage for Americans not covered through their jobs.
The expansion of ACA has increased the likes of Florida Medicaid applications and reduced the number of uninsured by 38%. As President Biden promised, the nation will hit its lowest uninsured rate when it offers more generous premium tax credits and reduces health care premiums for working families.
Further, the government’s involvement in negotiating drug prices is set to reduce the cost of prescription drugs. This is likely to save billions of dollars, but it might compromise research and development because the federal government wants to curb the rise of drug prices beyond inflation.
Improved Prescription Innovations
The establishment of Medicare increased the market for prescription drugs because more Americans could access prescriptions than in previous years. That was good news for pharmaceutical companies who viewed the Medicare markets as untapped opportunities.
These companies have been innovating in developing drugs purposely for the aged group. Indeed they want to support the industry which aims to create the best Medicare plans for senior citizens.
Further, Medicare part D caters to prescription drugs, and Medicare Advantage, provided by private insurance companies, gives beneficiaries better access to prescription medicines.
Medicare beneficiaries have enjoyed the benefits associated with these plans since 2006, and as a result, enrollments in MA-PDs are growing at a rapid rate. According to Kaiser Family Foundation, nearly 48 million Americans were enrolled in Part D of Medicare.
This enrollment growth in the Medicare prescription drug benefits has given pharmaceutical companies the impetus to develop drugs to cater to this market.
Increased Medical Standards
Congress submitted a set of standards after introducing Medicare and Medicaid programs. Since then, the government has been overseeing these standards. It also encourages the public to report hospital readmissions and infection rates.
Expansion Produces Net Savings for States
Tens of millions of older adults, younger people with disabilities, or Americans with limited resources have access to Medicare and Medicaid. These are the most successful social insurance programs in history. But the federal government expects the workforce to contribute their share in funding these programs through premiums that beneficiaries pay or payroll taxes.
These government-sponsored health insurance plans have received major funding since the CARES Act was enacted and the coronavirus outbreak. Higher Medicare enrollments have contributed to higher health spending, which is set to continue to grow.
At the same time, it has also dramatically lowered the rate of uninsured Americans. The covered households have become healthier and financially secure. Further, the Medicare tax that self-employed and salaried workers pay, coupled with federal government contributions, has helped offset the deficit caused by the expansion.
For instance, the federal government pays a bigger share of the cost of expanding Medicare coverage while states receive more revenue from taxes imposed on health plans and providers. So, the expansion has yielded net savings in many states, including Florida.
Medicare is government-sponsored health insurance with a great future because of the state and federal government partners to increase coverage. Pharmaceutical companies are investing in the production of prescription drugs for aged citizens. Therefore it’s good news for them when the federal government and states intensify their efforts to increase Medicare coverage.
Federal involvement in negotiating drug prices can help to limit the out-of-pocket costs attached to the medication in Part D. These initiatives will enable millions more Medicare beneficiaries to access health insurance.