- Section 1 Introduction
- Introduction
- Federal Government Administration
- Fundamentals of Medicare: State Responsibilities
- Fundamentals of Medicare: Participating Providers
- Voluntary and Involuntary Termination of Provider Agreement
- Disclosure of Health Insurance Information
- Privacy Act
- National Provider Identifier
- Legacy Provider Numbers/Provider Transaction Access Numbers (PTANs)
- Medicare Administrative Contractors
- Fundamentals of Medicare: Information References
- Acronyms
- Fundamentals of Medicare: Glossary of Terms
- Section 2 Medicare Basics
- The History of Medicare
- What Is the Medicare Program and How Is It Funded?
- Medicare Eligibility and Premiums
- The Social Security Administration and Medicare Enrollment
- The Medicare Card
- Medicare Part A
- Inpatient Hospital Care
- Skilled Nursing Facility Inpatient Care
- Home Health Care Benefit
- The Hospice Benefit
- Medicare Part B Medical Insurance
- Fundamentals of Medicare - Medicare Program Exclusions
- Medicare Advantage Organizations
- Medicare Secondary Payer
- Supplemental Insurance
- Coordination of Benefits Trading Partners
- Section 3 Fraud and Abuse
- Section 4 Getting Ready to Bill Medicare
Section 2: Medicare Basics
The History of Medicare
During the 30 years following the passage of the SSA in 1935, many attempts were made to include health insurance as part of the Social Security system. It was not until the bill H.R. 6675 was introduced in March 1965 that the health care programs for persons aged 65 and older were on their way to becoming a reality. The hospital insurance program would be financed mainly by a payroll tax that would be handled by the Social Security system. The medical insurance program would be voluntary and would pay physician costs and other expenses not covered by the basic compulsory plan.
On 7/30/1965, President Lyndon B. Johnson signed Medicare into law as an amendment to the SSA. The bill to create the program was passed by the House of Representatives with a vote of 307 to 116 on 7/27/1965, and passed by the Senate with a vote of 70 to 24 on 7/28/1965. Another amendment to the SSA, one that authorized the Medicaid program, was also enacted on this date.
The bill was signed in Independence, Missouri, in a ceremony honoring President Harry Truman, who in 1945 proposed federal health insurance under Social Security. President Johnson said, “We marvel not simply at the passage of this bill, but that it took so many years to pass it.”
Note: Former President and Mrs. Truman were honored with the first two Medicare cards. The first day that the Medicare Program was in effect was 7/1/1966.
When implemented, Medicare covered most persons age 65 and over. In 1973, legislation added other groups to Medicare entitlement such as certain disabled people, people with ESRD and specific otherwise noncovered persons who elect to buy into the program.
Enrollment in the Medicare Program has grown from 19 million people in the 1960s to 37 million by 1995 and to over 41 million by 2004. There are now over 53 million beneficiaries.
Medicare is an ever-changing program. However, change is not instantaneous. Since all program changes require an Act of Congress, it can take years for a change to be implemented. Even if many people believe it is a worthwhile addition to the program, e.g., prescription drug coverage, a proposal has to be created, win the majority vote in Congress, and there has to be funds available in the Medicare budget.
Revised 1/2021