History of medicare advantage plans?
Whether you’re a retiree, a healthcare professional or just someone who loves learning about the madcap world of medical insurance, you’ll be sure to get a kick out of the wacky history behind Medicare Advantage plans. Many people think that these innovative insurance policies are unique to our times but, in fact, they have been around for over half a century. So put on your thinking cap and let’s plunge into the outrageous story of how we got to where we are today.
The Birth Pangs
Medicare was first introduced in 1965 as part of President Lyndon B Johnson’s Great Society program. At the time it only covered hospital expenses – leaving wary Americans unsure whether their doctors’ bills would bankrupt them or not (which makes us wonder why anyone thought this was a good idea). Hence commenced years upon years worth waiting…..80’s babies where y’all at?
Enter Managed Care
By the early ’70s (no offense if you were born then) Congress started looking for ways to control rising healthcare costs while still providing valuable coverage to seniors. Enter: managed care! This refers (that’s fancy talk)to health plans which limit patients’ choice of physicians and other providers in order to keep expenses down.
And thus began the era of HMO-managed services boom-betrays-patient Humana came along with one exception- Humana Gold Plus plan circa 1986 boasted more benefits than regular ol’ medicare
Heritage Health Insurance
A major provider known today known didn’t always go by “heritage.” In fact It all started in Washington state when Faye Brown asked her surgeon what his cash-pay fee would be because she could not afford medical procedures after losing her job. Her physician agreed he saw business model here….The foundation had been laid!
Wait A Minute…
As radical (and awesome) as managed care sounds, it wasn’t until the 1980s that Medicare first started testing out what we now know as Medicare Advantage. Want to guess how long enrollees had to stick with an HMO before the Centers for Medicare & Medicaid Services let them change into a plan they could actually use? A full year! Yikes!
The Tumultuous ’90s
The early ’90s was a time of upheaval for medical insurance. New plans like PPOs (Preferred Provider Organizations (and no, not Pop Pop Outfits) and POS’s (Point of Service plans) were making waves – but so were old-fashioned fee-for-service policies which stuck around despite new kids on the block.
Henceforth began more options available beneficiaries!
Private Fee-For-Service Plans
If you thought fee-for-service insurance was gone forever in the post-’80s era of managed care then think again! Private Feefor service plans became newly introduced in ‘97 portrayed as potential triumph by advocates; freeing patients from unmerciful restrictions set down by previous insurers.
Regulating HMO’s Accessibility
With passage of Bill Clinton’s Balanced Budget Act from Congress pre-existing condition limitations dropped. Lofty enthusiasm arises surrounding protection to healthcare assets.’ This brought forth many shifts including requiring HMO’s hold hope-call clinics with number accessible after hours
Open season: once a year beginning bit
“Open enrollment period,” also known as Annual Enrollment Period started Friday following Thanksgiving up untill mid December giving potential buyers window to get preferential rates
Enter Part D prescription coverage
Next game changer – access to previously expensive drugs at relatively lower costs due largely in part because fo the cap that limits co-pay amounts per coverage term starts regaling American seniors in 2006
The Modern Age
We’ve journeyed through decades filled with turmoil and uncertainty, booms and busts, jubilation and heartache. Now we come to the present day where countless Americans rely on Medicare Advantage plans to help them pay for their medical bills…
The State of the Industry
With 22+ million beneficiaries in July 2021 (the highest yet) as enrolment rises along more traditional forms of insurance subscribers are being won over by a broad range of benefits like discounted gym memberships (which let’s be honest is a huge perk conducive to whole body health) dental coverage, vision care options either totally free or at a reduced rate
Compare that with Medicaid which only has just over (just under you know what happens when liars go wireless – Lionel Richie circa 1987) seventy two million users
New organizations: CAHPS
Client Assessment of Health Plans Study became regimen promoted provides consumers active voice when it comes to selecting new coverage through surveys all these years later
Lots Of Choices Out There!
It’s no longer law that beneficiaries stick with one HMO plan every year instead clients have numerous options offered according entirety entire nation depending upon location annual rates may differ signicantly before finding comfortable fit.
Wrapping Up Our Journey
From pre-existing condition exclusions and waiting tough times restrictions rampant practice. But current era offers hopeful possibilities abundant capabilities coming in diverse variety choices choices choices! As we move forward into the unknown landscape ahead there’s sure hope for yet even more innovation and affordability provided through Medicare Advantage program. Truly some things never change but sometimes our ability to make significant changes thereby sealing the future holds strongest truth – this was it – The History You Never Knew about Medicare Advantage Insurance Programs
Hey there, I’m Dane Raynor, and I’m all about sharing fascinating knowledge, news, and hot topics. I’m passionate about learning and have a knack for simplifying complex ideas. Let’s explore together!
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