Why does Medicare have so many coverage gaps, and is it designed that way on purpose?

Answered by 3 licensed agents

In 1965, the government set up Medicare to help primary care for those over 65 with healthcare costs. President Johnson set it up to share healthcare costs between the government and beneficiaries. This was called the cost-sharing approach, with the intent to help control Medicare abuse and overcharge by discouraging unnecessary use of the services.

Today, with healthcare costs rising, the original design has revealed six major gaps in its coverage. Therefore, yes, I think it was designed this way in the beginning, which makes it very confusing today. You need to make sure you have the right coverage and can’t afford the coverage of these gaps.

Answered by Larry Dalton on April 2, 2025

Broker Licensed in OK & TX

Answered by Larry Dalton Medicare Insurance Agent
When clients ask me this question, I usually answer, "To keep me busy". Seriously, it is an ever changing maze of rules and regulations. Once you think you have everything figure out, the government changes something and throws a curve ball. Working with an independent insurance advisor, allows you to reach out if you have an issue or a question and any point during the year.

Answered by Amy Putrino on March 25, 2025

Agent Licensed in RI, CT, FL & 11 other states

Answered by Amy Putrino Medicare Insurance Agent
Original Medicare was designed to provide Hospital Services and Doctor Services. However, with those gaps in coverage, Medicare Advantage and Medicare Supplement plans were offered help fill in some of the gaps. With most Medicare Advantage plans offering Dental, Vision and Hearing; and Medicare Supplements plans providing additional benefits for the Hospital and Doctor Services portions.

Answered by Denise Berg on April 2, 2025

Broker Licensed in CO, AL, AZ & 15 other states

Answered by Denise Berg Medicare Insurance Agent

Tags: Agent Interview Coverage The Medicare System

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