HealthInsurance.com by TogetherHealth logo
Find a Medicare plan
Get Started →
Medicare by location > Medicare in Oklahoma: How to Apply, Costs, and More

Medicare in Oklahoma: How to Apply, Costs, and More

Medicare in Oklahoma: How to Apply, Costs, and More

Medicare is a federal program that provides health coverage for individuals 65 and older, people under 65 who have been receiving Social Security Disability benefits for a certain period of time, or individuals under 65 with end-stage renal disease (ESRD).

More than five million people are enrolled in some type of Medicare plan in Oklahoma, including:

  • 2.3 million Medicare Advantage beneficiaries
  • 3.2 million Prescription Drug Plan beneficiaries

Whether this is your first introduction to Medicare in Oklahoma, or you're navigating potential changes in your plan, understanding the qualifications and what applies to your unique situation can be difficult. This guide answers some of the most common questions about Medicare in Oklahoma.

Who Qualifies for Medicare in Oklahoma?

Because Medicare is a federal program, the qualifications are the same in every state. You're eligible for Medicare if any of these situations apply to you:

  • You're over the age of 65
  • You're under the age of 65 with kidney failure
  • You're under 65 and receiving SSDI

There are four parts of Medicare:

Different premiums apply for each part of Medicare, depending on your coverage choices.

You may be eligible for premium-free Medicare Part A under these circumstances:

  • If you're over the age of 65, and you or your spouse paid Medicare taxes for at least 10 years, you are eligible for Medicare Part A at no additional cost.
  • If you are over 65 and receiving, or eligible to receive, retirement benefits from social security or Railroad Retirement, you may also receive Part A with no premium.
  • If you have been entitled to get Social Security benefits or Railroad benefits for two years, or you are a kidney transplant patient or currently receiving dialysis treatments, you may be eligible to receive Medicare Part A with no premium.

How Do I Apply for Medicare in Oklahoma?

There are several ways to apply for Medicare in Oklahoma. If you are already receiving certain benefits, you may already be automatically enrolled. For example, if you already get benefits from Social Security or the Railroad Retirement Board, you're automatically eligible for Medicare Part A and Part B.

If you're under the age of 65 and have been entitled to disability benefits under Social Security or the Railroad Retirement Board for 24 months, you'll automatically be enrolled in Medicare Part A and Part B at the beginning of the 25th month of eligibility.

In either of these circumstances, you don't have to do anything to enroll. Your Medicare card will automatically be mailed to you about three months before your effective date.

If you're not currently receiving retirement benefits, but meet the Medicare eligibility requirements, there are a few different ways you can apply.

  • Enroll over the phone by calling the Social Security Administration at 1-800-772-1213
  • Enroll online for Medicare only
  • Visit your local Social Security office in person

If you're already enrolled in Part A and wish to enroll in Part B, you can apply online or by mail during a special enrollment period.

What Does Medicare Cover in Oklahoma?

Your Medicare coverage depends on the plan(s) you choose. Medicare is divided into four general parts and also provides options for additional coverage (Medigap) to help with additional costs. Medicare Part A and B make up Original Medicare and provide coverage for hospital and outpatient medical care. Part C is known as Medicare Advantage and is an alternative bundle that usually replaces Part A, B, and D. Medicare Part D provides prescription coverage.

Part A (Hospital Coverage)

Medicare Part A is part of Original Medicare. It provides coverage for in-patient hospital services, including:

  • In-patient hospital care
  • Skilled nursing facility care
  • Nursing home care
  • Hospice care
  • Home health care

Some copays and deductibles apply and some services may not be covered in certain situations. Talk to your doctor or health care provider to discuss covered services.

  • Part B (Medical Coverage)
  • Part B is also part of Original Medicare. It covers outpatient medical services (like your routine doctor visits), including:

Medically necessary services: Services and supplies needed to diagnose and treat your medical conditions Preventive services: Health care to prevent illness or detect it at an early stage

Most preventive services are covered at full cost. However, deductibles and copays usually apply for medically necessary services.

Part C (Medicare Advantage Coverage)

Usually referred to as Medicare Advantage plans, Part C usually covers Part A, Part B, and Part D in a bundled insurance policy. There are four basic types of Medicare Advantage Options with varying levels of coverage:

  1. Health Maintenance Organizations (HMO): Covers preventive medical care and pharmacy services supplied by a specific provider in a certain geographical location. Some emergencies are covered at facilities outside the normal service area
  2. Preferred Provider Organizations (PPO): Typically covers all services by any doctor or provider that accepts Medicare. You don't need a referral to see a specialist, but out-of-network providers or non-preferred providers will likely cost you more
  3. Private Fee for Service (PFFS) Plans: These plans offered by private companies include coverage for Medicare-approved hospitals and doctors and may include prescription coverage. Extra benefits may be included since the private company, rather than Medicare, how much it will pay and what you pay for the services you get
  4. Special Needs Plans (SNP): Coverage for people who either live in institutions or require nursing care at home, are eligible for both Medicare and Medicaid, have one or specific chronic or disabling conditions.

Part D (Prescription Coverage)

Medicare Part D provides coverage for prescription medicines. A variety of plans are available that provide coverage for different medications. Each plan includes a formulary (list of covered drugs) which may change at any time.

How Much Does Medicare Cost in Oklahoma?

The cost of your Medicare plan in Oklahoma may vary depending on your choice of coverage, your income, and the amount of time you worked before you retired. Medicare costs include monthly premiums, deductibles, and copays.

Part A

Original Medicare (Part A and Part B) has uniform costs across all states. Most people don't pay a premium for Part A. If you don't qualify for premium-free Part A, the standard premium is $471. Deductibles and copays for Part A include:

  • $1,484 deductible for each period
  • $371 coinsurance per day for in-patient stays ranging from 61 to 90 days
  • $742 coinsurance per day after 90 days spent in the hospital (Note: these lifetime reserve days have a limit of up to 60 days in your lifetime)

Part B

Costs for Part B will include monthly premiums, copays, and deductibles. Monthly premiums for Part B depend on your annual income. The standard monthly premium for Part B is $148.50. Most people pay this amount. However, if your annual income is more than $88,000 (or $176,000 for couples filing jointly), you may have to pay more.

Deductibles and copays for Part B include:

  • $203 deductible for the year
  • 20% copay after the yearly deductible is met for most doctor services, outpatient therapy, and durable medical equipment (DME)
  • 20% copay for mental health care services after the deductible
  • Deductible usually applies to Part B services with the exception of preventive services.

Part C (Medicare Advantage)

The part C Medicare monthly premiums, deductibles, and copays vary by plan. The average monthly Medicare Advantage premium in Oklahoma is $14.65 in 2021. This cost is paid along with your monthly premium for Medicare Part B.

Part D

Prescription coverage costs vary by plan and are based on your monthly income. Your monthly costs will include your plan premium and an additional fee based on income above $88,000 annually ($176,000 for couples filing jointly). Deductibles and copays may apply to prescriptions as well. 30 stand-alone prescription drug plans are available in Oklahoma. The lowest monthly premium is $7.80 for one of these plans. However, deductibles vary from one plan to the next, as do covered medications. Always check your plan to understand out-of-pocket costs and ensure your prescriptions will be covered by your plan.

Medigap

Medicare supplement plans are used to cover the costs of gaps in coverage left by Part A and Part B. These plans are available through private insurance companies and premiums vary by plan.

Medigap plans in Oklahoma are attained-age rated, meaning your premiums are based on your current age each year.

Medicare Advantage in Oklahoma

Every person eligible for Medicare is eligible for a Medicare Advantage plan. These plans are designed to bundle the benefits of Original Medicare and often include Part D prescription coverage within the plan. Medicare Advantage plans may offer additional services beyond Original Medicare like dental, vision, fitness programs or gym memberships, and adult day-care programs.

What is the Best Medicare Advantage Plan in Oklahoma?

The best Medicare Advantage plan in Oklahoma depends on your needs and budget. The Medicare Advantage plan you choose must be available within your zip code.

For most people, a PPO or HMO plan is the best Medicare Advantage plan in Oklahoma. However, if you have special needs, or suffer from certain chronic illnesses, a special needs plan (SNP) might provide more benefits. Choosing a plan will depend on your specific needs. Ask these questions to determine which plan is best.

  • Can I afford the yearly deductible?
  • Is dental care included?
  • Is vision coverage included?
  • Does the plan include prescription benefits?
  • How much is the monthly premium?
  • Is there an out-of-pocket limit?
  • What services are covered by the plan?

Learn More About Medicare in Oklahoma

Learning about your eligibility for Medicare and the options that best suit your needs can help you save on healthcare. Still, with all the choices available, getting the right plan can be a challenge. Whether you want to compare Medicare plans in your area or talk to a Medicare advisor, we're standing by to help. Finding your Medicare plan just got simpler. Get started right away.

What you should read next

Medicare In 2023: Changes & Updates

When planning ahead for your healthcare expenses and how they align with your Medicare coverage, it’s very important to stay informed on the changes to Medicare each year.  Several aspects of Medicare - particularly related to out-of-pocket costs - can change on an annual basis. Beyond costs or plan changes, Congress also occasionally proposes and passes legislation that often impacts Medicare benefits.  In this article, we’ll review the recent changes, including the 2023 Medicare costs and an overall look at the state of Medicare in 2023.  2023 Medicare Costs: An Overview  The Medicare costs that change each year are: Part A deductiblePart A daily coinsurancePart B deductible Medicare Part A CostsThe changes to Part A costs include:Part A deductible - $1,600, an increase of $44 from 2022Part A daily coinsurance for hospital stays over 60 days - $400 per day, an increase of $19 per dayPart A daily coinsurance for hospital stays over 90 days - $800 per day, an increase of $22 per dayPart A daily coinsurance for skilled nursing facility stays longer than 20 days - up to 100 days $200, an increase of $5.50 per month Keep in mind that it is possible to pay the Part A deductible more than once in a year. This would only happen when you have multiple hospital stays in one year, and your stays are separated by more than 60 days. In this situation, you’d pay the Part A deductible each time.When you pay the Part A deductible, that gets you 60 days in the hospital and 20 days in a skilled nursing facility. If your stay goes beyond those times, you’ll have to pay the updated daily co-insurance amounts indicated above. Medicare Part B CostsThe Part B deductible for 2023 decreased to $226. It was $233 for 2022. You have to pay the Part B deductible each year before Medicare starts  paying its portion of your outpatient care. Unlike the Part A deductible, you’ll only be required to pay the Part B deductible once per year.After you’ve met the Part B deductible, Medicare will pay the first 80% of the cost for your care; you’ll be responsible for the remaining 20%. Besides standard Part B coinsurance, you might encounter Part B excess charges, which can be as much as 15% of the Medicare-approved cost for your care.There were no changes to these coinsurance costs for 2023. How Much Will Medicare Premiums Increase in 2023? The standard Part B premium for 2023 is $164.90, which is a decrease of $5.20 per month. This decrease takes some of the sting out of last year’s increase, which was one of the largest in history. You may pay a higher premium for Medicare if you have incomes exceeding $97,000 (single filers) or $194,000 (married filing jointly).In addition to the costs for using your coverage, you’ll also have to consider the cost for getting your coverage. Most people don't have to pay a premium for Part A coverage (because it’s been pre-funded through payroll tax deductions), but you do have to pay a premium for Part B coverage. Medicare Part D Changes Another major component of your Medicare coverage is Medicare Part D, also known as Prescription Drug Plans (PDPs). Part D is offered by private insurance carriers with a Medicare contract - not offered by the federal Medicare program. There have been major changes to Part D in the past year as a result of the Inflation Reduction Act. Some of these changes won’t take effect until 2024 or later, but a few of them will be effective in 2023. The changes that will be applicable for 2023 include:Caps on the cost of certain insulinTaxes on excessive increases in the cost for prescription drugsLowering the cost of many vaccinations covered under Part DEach of these changes will have an impact on both standalone Part D Prescription  Drug Plans (PDP) and Medicare Advantage Prescription Drug Plans (MAPD). New Caps On Insulin PricesThe Inflation Reduction Act has brought us the Insulin Savings Program, which was a temporary “test program” that began in 2020. The program is now permanent and mandatory. But previously, it was optional: Part D plans could choose to participate on a voluntary basis.The Inflation Reduction Act limits monthly cost sharing for covered insulin products to no more than $35 for Medicare beneficiaries, as long as the insulin is on the plans formulary. No deductible will apply to these insulin prescriptions. For 2023 and beyond, insulin prescriptions are capped at $35 for a one month supply. This price level stays the same throughout the year, even if you enter the coverage gap or “donut hole.” Excise Tax On Excessive Cost Increases Cost increases on prescription drugs, which are set by the manufacturers, will be subject to a new tax beginning in 2023. Medicare will use 2022 drug prices as a baseline and will investigate the prices for 2023 prescription drugs. If the increases from 2022 to 2023 are larger than the official rate of inflation, the manufacturer will pay a tax equal to 100% of the amount that the increase exceeded inflation for the year. Drug prices will be tracked each year in this way. The hope is that manufacturers will be less likely to increase prices aggressively since they won’t be able to keep any of the extra revenue that large cost increases used to bring them.While this new policy doesn’t directly reduce or limit the prices you pay through your drug plan, over time, it may allow for smaller copayments and coinsurance for your prescriptions. Reduced Vaccine Costs Under Part D The Inflation Reduction Act is also impacting how much you’ll pay for vaccinations under Part D. Prior to 2023, most non-essential vaccines were subject to cost-sharing, which meant that you had to pay a copayment or coinsurance for them. For example, the shingles vaccine was famously expensive. For 2023 and beyond, many Part D covered vaccines will be available at no cost. This brings the Part D vaccinations into alignment with the rules and cost structure for Part B vaccines (like the COVID-19 and flu shots). This includes the shingles shot, so protecting against this painful illness will be cheaper starting in 2023. There are still vaccines that you’ll have to pay for under Medicare, even after these recent changes. Vaccines that are needed to treat injuries or exposure to certain diseases may still require cost-sharing. General Enrollment Period (GEP) ChangesThe last major change to Medicare in 2023 relates to entering Medicare when you’ve missed your original enrollment window. Most people get to enter Medicare when they turn 65-years-old. In that case, you have a seven-month enrollment period known as your Initial Election Period (IEP) during which you can enroll. If you miss this chance, you have to enroll during the General Enrollment Period (GEP). GEP runs from January 1st to March 31st each year. Previously, if you enrolled during the GEP, your Medicare coverage wasn’t effective until July 1, which left you with a significant gap in your medical coverage.For 2023 and beyond, your coverage will be effective on the first day of the month after you sign up during the General Enrollment Period, eliminating the lengthy waiting period. Learn MoreIf you still have questions about 2023 Medicare costs and how they impact you, call 800-620-4519 to speak to one of our licensed insurance agents. You can also view our Medicare resources online:Compare Medicare plans: Visit our Medicare plan comparison tool.Learn about Medicare: View our Medicare Learning Center.Note: These 2023 Medicare costs and updates are courtesy of the Centers for Medicare & Medicaid Services (CMS). For more information, visit the CMS newsroom. 

10 Costly Medicare Mistakes to Avoid

Researching your Medicare plan and understanding how to use your benefits wisely is key to maximizing your Medicare plan. But if you don't take the time to learn all that your current plan has to offer, or if you avoid comparing Medicare plans when it may be time to make a change, you could end up paying more money for your healthcare.   To help you make an informed choice, we’ve put together this guide about 10 costly mistakes to avoid when picking a Medicare plan.   Mistake #1: Using Doctors And Medications That Are Not Covered By Your Plan Medicare Advantage plans have formal networks of providers and lists of medications that are covered (called a formulary). If you see doctors who aren’t in-network, you’ll be paying more for your care than if you use in-network providers. While some PPO plans will allow you to see non-network providers, you’ll save the most money when you use in-network providers. In the same way, plans only provide coverage for medications that are on the formulary. If you use non-covered medications, you’ll end up paying full price for them. So if your current plan doesn’t work with your doctors and medications, you may want to consider making a change to your coverage a qualifying enrollment period.  Our online guided Medicare enrollment tool also allows you to check and see if your doctor and drugs are covered in a Medicare Advantage plan.   Mistake #2: Not Taking Advantage of Additional BenefitsOne of the reasons Medicare Advantage plans are increasingly popular is because they usually provide benefits that are not covered by Original Medicare. These kinds of benefits can include dental, vision, hearing, or prescription drug coverage.These benefits also may be included in your plan at no additional cost. If you don’t use them, you might be paying more than you need to for these services. In addition to the potential cost savings, these additional benefits are designed to help you live a healthier life. Mistake #3: Paying Cash For Your MedicationsIt can be tempting to pay cash for some of your less expensive medications. This is especially true when you look into any of the various prescription discount card programs that are currently available. However, it's wise to avoid paying for your medications if you're expected to reach the third coverage stage of the Medicare Part D drug program (often called the donut hole). Your drug plan tracks your spending, so if you pay cash for a prescription, it doesn’t count towards your official spending. This means that you might not be able to move out of the donut hole if you pay cash for some of your medications. Instead, consider using your plan even if you’ll pay more, if it means that you’ll move out of the donut hole faster. Mistake #4: Not Understanding Your Plan’s CostsWhile Medicare Advantage plans generally help to limit your healthcare costs, it’s important to remember that there are costs you’ll be expected to pay for your care. These costs are usually referred to as cost-sharing. Cost-sharing can include deductibles, copayments, and coinsurance. Besides these amounts, you’ll want to double check your plan’s Out-of-Pocket Maximum (OOPM), which is the most you could possibly spend in one year.  Mistake #5: Choosing A Plan Based On Premiums AloneIt can be tempting to focus on the monthly premium you pay for your coverage, and not dig deeper into the costs you’ll pay to use your benefits. Pay particular attention to any deductible that you have to meet, as well as co-payments for services you’re likely to use. Besides these, consider your total costs in light of any costs for prescription drugs you take, too. Mistake #6: Not Checking To See If You Qualify For Financial AssistanceThere are a number of federal and state programs that are designed to help you pay for the cost of your health care. These can include Medicaid, Extra Help, Low Income Subsidy, and state pharmaceutical assistance programs. While there are income and asset limits for participation in some of these, you should apply for them if you think there is any chance that you could be eligible. Many times the limits are dependent on household size so you may qualify even if your income appears to exceed the limits. The upside is huge and there’s no downside to applying, so don’t miss out any potential for savings with these programs. Mistake #7: Not Considering Late Enrollment PenaltiesIt’s very important to consider the impact of late enrollment penalties, especially when you’re first entering Medicare. You can potentially be subject to enrollment penalties for both Part B and Part D. These penalties are assessed in the form of an additional monthly premium. Importantly, these penalties are generally permanent; once you’re subject to them, you’ll pay them for the rest of your life.If you’re already in Medicare, and you have avoided late enrollment penalties so far, just make sure that you continue to have Part D drug coverage, either from a Medicare Advantage Plan or a standalone Prescription Drug Plan.Mistake #8: Not Reviewing Changes In Your CircumstancesIt's important to review any changes in your circumstances on an annual basis. If you’ve been referred to a new specialist, prescribed a new medication, or diagnosed with a new medical condition, you might be better served by a different plan for the new year. So be sure to consider the impact these kinds of circumstances may have on your Medicare coverage.  Mistake #9: Automatically Renewing Your Plan Each YearEach year, your plan will mail your Annual Notice of Change (ANOC) before the fall Annual Enrollment Period (AEP). The ANOC outlines changes in your plan benefits or costs for the upcoming year. Use this document, along with your plan’s overall Evidence of Coverage (EOC) to know how to use your benefits for this year.If you don’t make a change during AEP, you’ll automatically stay in your current plan. But plan benefits change from year to year, as do Medicare Advantage plan networks. So it's essential to review your coverage each year. Mistake #10: Not Working With A Licensed Insurance AgentAs you research the plans available in your area, consider working with a licensed insurance agent like one of our TogetherHealth agents. We work with a network of the nation’s major insurance carriers and can provide you with a variety of plan options to fit your healthcare needs, remain in-network with your doctors, and give you strategies to save money on prescription drugs.  Get Help With MedicareIf you need more guidance, call 1-800-620-4519 (TTY 711) to speak to one of our licensed agents and get advice on how to avoid these 10 costly Medicare mistakes.

How Healthcare Has Changed Over the Past Quarter Century

With the 2020s underway, let’s take a look back at seven key milestones and issues that marked the evolution of healthcare over the past 25 years. 1. The Affordable Care Act became law Just months into 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. The Affordable Care Act, often referred to as the ACA or Obamacare, changed the nation’s health insurance landscape and  brought about numerous provisions to help make health insurance more affordable and accessible to as many Americans as possible. Some key provisions include: The creation of a health insurance marketplace in every state to provide consumers with a place to purchase health insurance.Income-based subsidies, including premium tax credits and cost-sharing reductions, for those who purchase individual coverage through the health insurance marketplace (i.e., the state-based and federal exchanges).A requirement that insurance plans cover young adults on their parents’ policies to age 26.Guaranteed issue and renewal of policies.Medicaid expansion to those with incomes below 138% of the federal poverty level, in participating states. Ten years later, uninsured rates have declined. In 2010, nearly 16% of Americans were uninsured. But in 2016, the uninsured rate hovered just above 8% - its lowest point in the decade. Although, it started to increase again slightly in 2017.2. Short-term health insurance kept its strideShort-term health insurance is temporary insurance that provides coverage in certain medical situations like an unexpected accident or illness. However, it doesn't include the same essential health benefits that ACA plans do, making it a more affordable insurance option for many.Short-term health plans remained a relevant health insurance option throughout the decade with sales increasing sharply after the ACA took full effect in 2014. These plans became an attractive option for people who were exempt from the individual mandate or opted to pay a penalty for not having an ACA-compliant health plan.Obama limits short-term policiesConcerned that short-term health insurance was impacting ACA enrollment, the Obama administration created regulations that limited their availability. In 2016, short-term policies were capped at three months.Trump expands short-term policiesIn 2018, the Trump administration lifted Obama-era limits. Policies can now last up to 12 months and can be renewed for up to 36 months, depending on state laws. Arizona, for example, has adopted the Trump administration’s regulation. Some states, such as Oregon, still limit short-term plans to less than 90 days.3. High-deductible health plans grew in popularityHigh-deductible health plans, called HDHPs, were introduced in the early 2000s and  were considered "mainstream plans" by 2012. People obtained these plans usually through their employer group-based coverage (if offered), the healthcare exchange, or from private insurers. Here are some interesting facts:HDHP enrollment jumped from 10 million people to 11.4 million people in one year (from January 2010 to January 2011).By 2015, HDHPs accounted for 60% to 80% of plans offered in the individual health insurance marketplace. In 2019, the IRS classified high-deductible health plans as any plan with a deductible of at least $1,350 for an individual and $2,700 for a family. The average annual deductible for individual coverage through a group plan was $1,655 in 2019.But while consumers can appreciate the lower monthly premium of a high-deductible insurance plan, they also tend to delay or skip medical care because of the high out-of-pocket costs associated with HDHPs.The popularity of HDHP may be slowing - at least in the group market. The percentage of employers offering a high-deductible health plan as the only option is projected to decrease in 2020, with more employers beginning to offer additional coverage options.4. Healthcare spending continues to climbIf it seems like your healthcare costs increased throughout the past decade, it probably did. In 2018, the average American household spent $5,000 on healthcare, with nearly 70% of the $5,000 going towards health insurance.The more staggering fact: medical bills are reported to be the number one cause of bankruptcies nationwide. And today, medical costs are considered America’s "real healthcare crisis". And while politicians continue to debate issues including health insurance reform and prescription drug pricing, they have not agreed upon a clear solution.Until things change, consumers must continue to find ways to save on their own, from finding flexible and affordable health insurance options and taking advantage of preventive care, to comparing provider rates before seeking services and getting alternative healthcare through options like telemedicine.5. An opioid epidemic devastates our nationThe opioid epidemic might be the most daunting and complex public health crisis of our time. Heroin-related overdoses increased 286% from 2002 to 2013, with a significant spike around 2010. Another wave of opioid-related deaths hit around 2013 and this time, synthetic opioids like fentanyl were behind the surge. The crisis continued to escalate from there, with prescription drugs playing a significant role. Here are some of the most shocking reports:Opioid overdoses accounted for more than 42,000 deaths and increased to 47,600 people in 2017. By 2019, more than 90 Americans per day were dying from opioid overdose. And prescription opioid abuse was costing the nation $78.5 billion per year.The epidemic impacted people in both rural and urban environments. But overdose deaths in rural communities surpass deaths in urban settings. So what’s being done about it? In early 2019, the Trump administration launched a $353 million initiative to cut opioid overdoses by 40% over the next three years. The federal government is also working to hold drug companies accountable. For example, top executives at Insys Therapeutics were found guilty of racketeering conspiracy—a charge typically assigned to drug dealers and mob bosses. In 2018, the CDC reported that drug overdose deaths decreased for the first time since 1990.6. Covid-19 pandemic and the U.S. healthcare systemThe 2020 pandemic was not only the biggest health event in the U.S. in the past decade, but a major burden on an already fragile healthcare system. From shortages of hospital beds and staff to healthcare facilities having to ration medical supplies to keep up with COVID-19 cases, we’ve seen how our healthcare infrastructure is in need of improvements to better prepare for crises. Not only that, researchers at the Massachusetts Institute of Technology assert that the pandemic revealed some deeper issues in our healthcare system, such as disproportionate access to care among marginalized groups and the country’s dependence on healthcare services from underpaid workers.7. Medicare enrollment: Medicare Advantage Plans and Original Medicare Medicare Advantage plans, which are an alternative to Original Medicare, have seen a steady increase in enrollment each year over the past decade. As of 2022, there are 28.4 million Medicare Advantage enrollees which account for 48% of the Medicare-eligible population. People enrolled in MA plans back in 2012 represented about a quarter of all beneficiaries, so enrollment rates have just about doubled.Another interesting fact as reported by Kaiser Family Foundation is that “the average Medicare beneficiary in 2022 has access to 39 Medicare Advantage plans, the largest number of options available in more than a decade.”Here’s a breakdown of MA plan enrollment:About two-thirds (18.7M) of the Medicare population are enrolled in a plan available through individual enrollment.Roughly 5.1 million beneficiaries have coverage through an employer or union group plan available to retirees.More than 4.6 million people are enrolled in Special Needs Plans, the majority of which (89%) are those eligible for both Medicare and Medicaid. The healthcare debate continuesDiscussions about healthcare reform and our healthcare landscape did not stop when the ACA was passed. Conversations about legal challenges continue to this day. There has been proposed legislation to repeal and replace the ACA under the Trump administration. Trump administration removes individual mandateNew tax legislation  passed in December 2017, which changed one key aspect of the ACA. Previously, you could be penalized for not having health insurance, but Congress and President Trump eliminated the mandate rule for all coverage beginning Jan. 1, 2019. Individual mandate challenged as unconstitutionalThe 5th Circuit also ruled in Texas vs. United States that the individual mandate is unconstitutional, at which time, a A Texas Judge was deciding what, if any, of the ACA still stands. But in 2021, the Supreme Court ruled that states don’t have any grounds to challenge the constitutionality of the ACA mandate.The 2020 electionWith the Presidential election in 2020, Democrats were focused on building upon the ACA with tactics like a “Medicare for all” national health insurance system. However, this agenda never took effect with the Democratic party winning the election. Now twelve years after the passing of the ACA, the Biden-Harris administration has promised to continue upholding the ACA and making affordable health insurance accessible. With ongoing talks of a universal health insurance option for Americans and how to navigate health-related issues post pandemic, there’s no doubt that healthcare legislation will continue to make headlines over the next decade. From Obamacare to the opioid epidemic to the Covid-19 pandemic, healthcare-related issues have made major headlines. And it’s inevitable that they’ll only continue to evolve and impact our lives for years to come. We’ll continue to follow the trends and changes as well as their impacts on our nation. 

Welcome to HealthInsurance.com
Privacy PolicyTerms and ConditionsCalifornia Privacy NoticeDo Not Sell My InfoInterpreter ServicesNotice of Nondiscrimination
GENERAL DISCLAIMERS
Healthinsurance.com, LLC is a commercial site designed for the solicitation of insurance from selected health insurance carriers. It is not an insurer, an insurance agency, or a medical provider. Insurance agency services may be provided by one of our sister companies, Total Insurance Brokers, LLC, TogetherHealth PAP, LLC, HealthPlan Intermediaries Holdings, LLC, or HealthPocket d/b/a AgileHealthInsurance Agency, which are all part of the Benefytt Technologies, Inc. family of companies.
Alternatively, you may be referred, via a link, to a selected partner website, which is independently owned and operated and may have different privacy and terms of use policies from us.
If you provide your contact information to us, an insurance agent/producer or insurance company may contact you.
If you do not speak English, language assistance service, free of charge, is available to you; contact the toll-free number listed above.
For a list of all available plans, please contact 1-800-Medicare (TTY users should call 1-877-486-2048) or consult www.medicare.gov.
This site is not maintained by or affiliated with the federal government's Health Insurance Marketplace website or any state government health insurance marketplace.
MULTI-PLAN_TGH-HPIH_WEB_M
© 2021 HealthInsurance.com LLC