Throwback Thursday: The Evolution of Medicare—From 1965 to Today

Welcome to Real Easy Medicare with Al Kushner! In this Throwback Thursday episode, Al journeys through six decades of Medicare history to explain how past legislation shaped today’s system—and why those origins still matter for your coverage.

1. 1965 Birth of Medicare
   • Johnson signs the original law; Truman is beneficiary #1
   • Part A & Part B only; $3 Part B premium (~$25 today)
2. 1972 Disability & ESRD Expansion
   • Coverage for permanent disabilities and end-stage renal disease
   • 24-month Social Security Disability waiting period
3. 1992 Medigap Standardization
   • Introduction of Lettered Plans A–J for consistent benefits
   • 2020 discontinuation of Plans C & F for new enrollees
4. 1997 Balanced Budget Act
   • Birth of Medicare Advantage (Medicare Plus Choice)
   • Early struggles paved the way for today’s MA plans covering over half of beneficiaries
5. 2003 Medicare Modernization Act (Part D)
   • Creation of outpatient prescription drug coverage
   • Initial rollout chaos; eventual elimination of the “donut hole” in 2020
6. 2008 MIPPA
   • Required observation-status notice within 24 hours
   • Expansion of Medicare Savings Programs
7. 2010 Affordable Care Act
   • Preventive services at no cost; Annual Wellness Visits
   • Growth of Accountable Care Organizations
8. Recent Reforms (2018–2024)
   • Chronic care management codes; telehealth expansion
   • 2025 cap on Part D out-of-pocket costs; drug-price negotiations

Why History Matters: Each addition—Parts A through D, Medigap standardization, MA creation—was a targeted fix layered onto an evolving system. Knowing this helps you navigate today’s rules, deadlines, and plan options with confidence.

Next Up: Fast Friday Q&A—rapid-fire answers to listener questions about enrollment deadlines, prescription coverage, and billing surprises.