Understanding Health Care for Seniors in America
The American Association for Labor Legislation was created in 1906 to build a system of health insurance for Americans. It was during this time that America began recognizing the correlation between overall health and the foods and drugs consumed. A precursor to the current Food and Drug Administration, the Bureau of Chemistry, was also founded that same year. The original purpose of the Bureau of Chemistry was to oversee the labeling and packaging of over-the-counter medications. In 1915, the AALL drafted the first outlines of a basic health insurance program, although it was opposed by some entities. Some 50 years later in 1965, President Lyndon B. Johnson signed legislation that instituted medical health benefits for Americans over age 65. These health benefits were called "Medicare." Medicare continues today as a way for seniors to receive important health care services.
As of 2017, approximately 58 million Americans receive Medicare Parts A and B coverage, which are also called "Original Medicare." Of this number, just over 49 million participants are seniors and the remaining beneficiaries are younger people with qualifying disabilities. Although Medicare helps pay some expenses, it does not cover everything. For example, long-term nursing home care is not covered by Medicare. To cover these types of health care expenses, seniors can buy supplementary policies from private insurance companies. These Medigap policies work in tandem with Medicare to cover a broader range of expenses and services.
Medicare includes four different components. Medicare Part A covers inpatient hospital care, some types of home health care, and hospice care. Medicare Part B is the general medical insurance that covers clinical care from physicians and other providers, as well as other types of outpatient care. Part B coverage also pays for some medical equipment and home health care as prescribed by physicians. Medicare Part C is a different type of plan that may be available for some seniors, provided via private health insurance companies. Medicare Part D is the prescription drug coverage policy that assists with some of the costs of prescription medications. Medicare Part D requires a separate policy to receive these benefits.
People with low incomes can get health care via Medicaid, which is a state-implemented program designed to provide medical coverage for eligible people. Some seniors may be eligible for both Medicare and Medicaid, so these programs can work together to cover medical expenses. Medigap policies are licensed by individual states. This coverage pays the recipients' portions of Medicare-covered services, as well as possible additional services as outlined by individual policies. Most Medigap policies won't cover services that are not covered by original Medicare, including long-term care, vision care, dental care, private duty nursing, and hearing aids.
Some seniors opt to purchase long-term care insurance to help with services that may be necessary for the event of a chronic or debilitating illness. This type of policy can cover assisted living, nursing home care, and in-home care. Long-term care insurance would be purchased prior to needing this type of care, and people may pay premiums for many years before they actually need to use the coverage. Premiums can be expensive, and many Americans simply can't afford this expense. Medicaid may be an option for some people long-term care is needed but long-term care insurance has not been purchased. Many nursing homes neglect their patients' medical needs.
Learn more about Medicare and health care for seniors by visiting these websites:
- History of Medicare
- Your Medicare Coverage Choices
- The Medicare Program - A Brief Overview
- The History of Medicare
- Medicare Primer (PDF)
- Centers for Medicare and Medicaid Services - Fast Facts
- Quick Medicare Facts and Statistics
- Total Number of Medicare Beneficiaries
- Understanding the U.S. Health Care System
- Health in America
- Overview of American Health Care System
- What is Medicare? (PDF)
- The Current State of Medicare
- Medicare and Medicaid - What You Need to Know (PDF)
- Costs and How to Pay
- How do You Pay for Long-Term Care?
- If I have Medicare, How Can I Get Help Paying for Long-Term Care Needs?
- Does Medicare Pay for Long-Term Care?
- Medicare and Long-Term Care
- Paying for Long-Term Care Expenses - Medicare, Medicaid and Medicare Supplement Insurance Benefits
- What is Medicare Part A?
- What's Covered by Original Medicare?
- About Medicare: Alzheimer's and Dementia
- What Medicare Does and Does Not Cover
- Who is Covered by Medicare? (PDF)