My Medicare

Medicare.

The very word evokes both a sense of relief and a resounding groan for anyone eligible for it. So many “moving parts”, annual changes, costs, and rules. It’s enough to make most people pick just about anything else for a topic of conversation - yet so important.

The financial foundation for medical care for millions of disabled and retired citizens since Lyndon Johnson signed the Act in 1965, it effectively provides basic medical care through Medicare and Medicaid. In 2026, it is a critically necessary part of keeping some financial sanity: more people over 65 go bankrupt over medical than anything else. I am going to untangle this ball of rattlesnakes for you until it feels like a walk in the park. Not in one article, but over many.

For those of you who didn’t live through the 60s, we had suffered through the Korean War (1950-1953) and entered the Vietnam war/conflict in 1955 which lasted until 1975.

In 65 there was no end in sight. People were financially reeling. We had just lost a beloved President, John F. Kennedy, in 1963 and no one trusted Johnson.

I remember the day Kennedy was shot: I was five years old, and my parents were watching the tv and crying. The soft-spoken, well dressed, Ladybird Johnson was the Wizard of Oz behind the curtain...a woman who probably had more to do with Johnson’s agenda than she was ever given credit for, and I wonder how much influence she may have had in this major Act (things that make you go ..hmmm).

As a nation, we had lost a sense of community, that cohesion the Great Generation had provided for so long was waning. Hippies were the Rebellious Generation, and the air was filled with anger, distrust and confusion. The Johnsons were shrewd people: Medicare had the ability to provide some relief and connected people in a way that made us all feel a little safer. Allow me to break down the parts of Medicare, just an overview.

Part A, Hospital coverage, prevented people from going broke over a hospital stay but there was a deductible and eventually, copays. Today, that is a lot: A rolling 60day deductible of over $1600, copays upwards of $400 per day after 60 days that go as high as $800/day. Part B was an 80/20 Medical plan without deductibles and minimal copays. For the disabled and financially vulnerable it was a safeguard against ruin. And it made people feel like the government was truly for the people at a time when, like today, we are all feeling like the world is on the brink of changes we probably don’t like. I digress.

Federal taxes increased on wages to support the program, the cost of part B could be deducted from your Social Security check, the cost was not oppressive, everything was rosy. Still, no one has ever been able to figure out why dental, vision and hearing are left out…it’s like we don’t have teeth, eyes or ears as part of our bodies, right? Probably because insurance bigwigs and the government saw an opportunity to make money on separate coverages and collect more taxes.

Over time, the cost of living grew but the Social Security increases were not keeping up. By 1975 Vietnam was over but the fallout was massive: many thousands missing, many more came home broken physically and emotionally. World War II Baby Boomers were aging out in a huge bubble (we still are, 40 years later).

United American Insurance Company developed the first Medicare Supplement plan in 1966, shortly after the Social Security Amendment of 1965 (the Medicare Act) was signed into legislation. Deductibles and copays for Part A and 20 percent on Part B were all covered. It wasn’t cheap, but it was manageable.

Part D, the Drug part, is and has always been a bone of contention. Your big annual book, “Medicare and You”, discusses the drug program on pages 30-55. They make very light of the fact that you are required to get a drug plan, or you will be penalized.

I once had a customer who called me in tears because she had never had one and she was 85 years old. She was diagnosed with cancer and had to get a plan to help cover her cost. When she took part D, the government sent her a penalty invoice for $285 a month. She was asking me for a way to relieve her. Since she was no longer financially solvent, she qualified for Extra Help through Social Security, and the program waived the penalty. But make no mistake: whether you need medication or not, you must have a drug plan. We will talk at length about the drug plan in another article; you can also listen to KALT this Friday morning at 9 a.m. when I speak with Jim Davenport on all things Drugs.

Part C is Medicare Advantage, the brainchild of John Kasich, a Republican Congressman from Ohio, and passed through a Republican Congress in a bipartisan effort under Bill Clinton who enacted the Balanced Budget Act of 1997. Originally called Medicare+Choice, it is private insurance under a Medicare contract that provides A/B/D payment management, extra benefits including dental, vision, hearing, spending money and more. Medicare Advantage is the reason for annual enrollment between October 15 and December 7 every year. Plans start on January one and usually cost zero premium. That is a financial discussion for another article, believe me. We all grew up on 80/20 plans with coinsurance, co-pays and deductibles - Medicare advantage is similar. It is a cost sharing system, which is preferred by both the government and the insurance companies because you are sharing the cost with them. unlike a supplement, or a Medicare/Medicaid arrangement which provides for zero out-of-pocket in most cases.

Hopefully this gives you some idea of how Medicare got started and where we are today in a high-level overview. In future weeks this column will deep dive into each piece, discuss pitfalls, loopholes, ways to save, and how to navigate many different situations. Stick with me and I’ll teach you how to make the system work for you, give you the information you need to make confident, informed decisions, and put you in control. Next week, because we are in annual enrollment and there are some looming challenges for 2026, I’ll be discussing the grocery card/allowance program and 2026 changes and challenges.

For those of you who prefer the digital experience, here’s a great article for your personal review if you’re interested. https://www.investopedia.com/9-major-medicarechanges- for-2026-whats-coming-for-premiums-drugprices- and-program-cuts-11831673 May the Lord bless and keep you, until we meet again. Amy

Amelia (Amy) Gunstanson is a Navy Veteran with 30 years’ experience in life and health insurance, the last 6 years in Medicare specifically. She is the Principal Agent/ owner of Medicare Thrive in Atlanta, TX, serving Cass and surrounding areas. She is federally certified, licensed in 20 states and appointed/certified with many major carriers including Kemper Life, Humana, United Healthcare, Physicians Mutual, Christus, Aetna, Cigna Blue Cross and more. You can call or text questions or requests for appointments to 430-999-2271 or on the web at www.medicarethrive. com.