ABSTRACT
Older adults are one of the few populations in the United States that has near-universal access to health insurance coverage, through the Medicare program. Medicare was established by Congress in 1965 amid growing recognition of the challenges many older adults faced accessing coverage and care after retirement. Medicare has four different parts representing different types of services that are covered and/or different modes of health insurance provision. Most recently, Medicare Advantage has been authorized by Medicare to develop Special Needs Plans (SNPs). Medicare SNPs offer disease management services and more affordable cost-sharing for medications and other services related to the beneficiary’s health condition. Rural-residing older adults with Medicare are more likely to be enrolled in traditional fee-for-service (FFS) Medicare policies than they are in Medicare Advantage plans when compared with urban elders. Despite the risk of out-of-pocket spending under FFS, however, nearly one in five beneficiaries in this traditional Medicare option go without supplemental policies.
