President Lyndon B. Johnson signed Medicare into law on July 30, 1965. Initially, Medicare was the basic insurance program for Americans who didn’t have health insurance, but access has changed over time.

What Is Medicare?

Medicare is the federal health insurance program covering people aged 65 and older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD). There are several parts to Medicare to cover different services. Part A is hospital insurance, Part B is medical insurance, and Part D is prescription drug coverage. The Medicare.gov website provides more information about the basics of Medicare.

The History of Medicare

Together, Medicare Part A and Part B are also known as Original Medicare because those were the two parts of Medicare when President Johnson signed the bill into law. Over the years, Medicare has expanded so more people are eligible for coverage. In 1966, over 19 million Americans enrolled, and as of 2021, Medicare now covers over 63 million Americans.

Additionally, coverage has also expanded over the years. Medigap, or Medicare supplemental insurance, was brought under federal oversight in the 1980’s, and coverage of home health services was expanded. The Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) approved private health plans called Medicare Advantage Plans, also known as Part C or MA Plans. In 2006, Medicare expanded again to add an optional prescription drug benefit (Part D).

There have been many milestones in the history of Medicare. For more information, you can view the “Medicare and Medicaid Milestones” publication from the Centers for Medicare and Medicaid Services (CMS).

The History of Senior Medicare Patrol

Unfortunately, along with the expansion of Medicare came the rise of scammers and Medicare fraud. A government-led project called Operation Restore Trust (ORT) was announced in 1995 to begin to combat Medicare fraud, abuse, and errors. ORT created a partnership within the U.S. Department of Health & Human Services (HHS) between the U.S. Administration on Aging (AoA), the Office of Inspector General (OIG), and the Centers for Medicare & Medicaid Services (CMS).

Then, in 1997, the AoA set up twelve local projects to recruit and train retirees to help their peers prevent, detect, and report Medicare fraud, abuse, and errors. The twelve projects were largely successful, and the SMP program has since expanded to a presence in all 50 states, Guam, Puerto Rico, the U.S. Virgin Islands, and Washington DC. Grants for SMP are managed by the Administration for Community Living (ACL). According to the ACL, there are more than 500 local sites, and over 6,800 team members between the staff and volunteers across the program.

What Does SMP Do?

Our mission is to empower and assist Medicare beneficiaries, their families, and caregivers on how to prevent, detect, and report health care fraud, abuse, and errors through outreach, counseling, and education. Since the program began in 1997 through 2019, over $129 million worth of recoveries and savings for Medicare, Medicaid, and beneficiaries can be directly attributed to SMP projects. We certainly couldn’t do what we do without the help of our volunteers, so please consider applying to volunteer with SMP if you also feel strongly about our mission!

As always, please call our toll free & confidential helpline at 888-818-2611 or send us an email at smp-wi@gwaar.org with questions, concerns, or to report suspected Medicare fraud. Just remember – don’t include any personal sensitive information in your message!