8 Stats You Might Not Know About Medicare

Important Medicare Statistics

1. The Medicare Program is Nearly 60 Years Old

Although Presidents Teddy Roosevelt and John F. Kennedy proposed their own versions of a national health insurance program, it wasn’t until 1965 that Lyndon B. Johnson signed H.R. 6675 into law, which established both the Medicare and Medicaid program. Nineteen million individuals signed up for coverage during the program’s first year.

Before, only a little over one-half of those aged 65 and over had some type of hospital insurance.

2. It’s Possible to Unenroll From Medicare

While you must enroll for Medicare around the time you turn 65, it’s a little-known fact that you can also unenroll from different parts of the national health program. However, there are different guidelines for each part:

Part A — You’ll need to complete CMS form 1763 (Request for Termination of Premium Hospital and Medical Insurance) and mail it to your local Social Security Administration office.
Part B — You’ll also need to fill out and file CMS form 1763 and attend a personal interview with a Social Security representative, whether in-person or over the phone.
Part C — You can unenroll from your Advantage Plan, switch to another plan, or revert to Original Medicare during the annual open enrollment period.
Part D — Unenrolling from Part D coverage occurs during the annual open enrollment period or after certain events like moving to a new address that’s outside your plan’s service area or losing your current coverage.

3. Medicare Does Not Cover All of Your Medical Expenses

For example, Part A only covers 80% of eligible expenses, leaving you responsible for the remaining 20%. Furthermore, Medicare completely precludes coverage for:

Acupuncture;
Cosmetic surgery;
Dentures;
Dental care (most);
Eye exams for prescribing glasses;
Hearing aids and exams;
Long-Term Care (also known as custodial care);
Routine foot care.

4. Medicare for All Would Broaden Healthcare Coverage to All U.S. Citizens

Instead of only individuals 65 and older, a single-payer Medicare for all program would cover all Americans and replace private insurance, employer-provided insurance, and Medicaid. The cost would amount to about $3 to $4 trillion per year, which is in line with current U.S. health care spending.

Related: What is Medicare For All?

5. There Are Hundreds of Ways Criminals Can Pull a Medicare Scam on You

According to ABC News, Medicare fraud costs taxpayers more than $60 billion each year. Some of the most common scams include:

Verifying your identity — Here, crooks try to get their hands on information on your Medicare card or even your credit card number to order a “new” card.
You’re due a refund — Criminals will claim that you’re owed a refund since you paid too much premium based on your coverage, and all you need to do is provide your bank account number to receive it.
Free gifts — Who could resist a free gift? All you need to do is hand over your name and Medicare number to a scammer.

Related: Common Medicare Scams

6. Medicare Covers Some Aspects of COVID-19 Infection

Another common scam is to call you out of the blue and convince you that you need to pay for a COVID-19 vaccine and that you’ll need to hand over your private information to do so. This is popular because Medicare covers:

FDA-authorized COVID-19 vaccines and related lab tests;
Antibody tests;
Monoclonal antibody treatments;
Medically necessary hospitalizations;
Expanded telehealth services.

7. Medicare is Mostly Funded Through Payroll Taxes

Most employees (those who earn less than $200,000 annually) pay 1.45% of their earnings to the Medicare program, and employers match another 1.45%, bringing the total payroll tax rate to 2.9%. If you’re self-employed, you’ll have to pay the entire 2.9%, although half is tax-deductible.

Keep in mind that if you’re single and earn more than $200,000 per year, you will pay a slightly higher rate of 2.35%.

Related: How Is Medicare Funded?

8. There Are Meaningful Differences Between Medicare and Medicaid

Medicare is a federal program that covers health care costs for individuals aged 65 and older and younger individuals with specific disabilities. Currently, Medicare covers about 44 million beneficiaries, which works out to roughly 15% of the population.

Comparatively, Medicaid provides health coverage to U.S. citizens in financial need (typically, those who fall at or below the Federal Poverty Level), which means that you can simultaneously qualify for both Medicaid and Medicare. As of 2018, Medicaid covered about 18% of the United States population.

Related: Medicare vs. Medicaid

IHS Insurance Group Knows All About Medicare

The team at IHS Insurance Group has decades of combined experience answering questions about Medicare, whether it’s related to enrollment, coverage options, or budget (or all of the above). We love answering your questions and ensuring you have a solid grasp of Medicare’s fundamental aspects, so you can make the most informed decision possible!

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Michael Steele