Original Medicare is a form of health insurance coverage that is administered by the U.S. federal government. This type of coverage is available for those who are 65 years of age or older, certain individuals with disabilities, and those with End-Stage Renal Disease (ESRD). It consists of two parts: Part A (Hospital Insurance) and Part B (Medical Insurance).Part A covers inpatient hospital care, limited skilled nursing care, hospice care, and some home health care.
Part B covers certain doctor's services, outpatient care, preventive services, and durable medical equipment. It also covers certain preventive services. The goal of Original Medicare is to help individuals pay for certain medical expenses when they are unable to do so themselves. It is important to understand the details of Original Medicare coverage so you can decide if it is the right choice for you and your family. This article provides an overview of Original Medicare, including its benefits, eligibility requirements, and how to enroll.
Original Medicareis the federal health insurance program that provides coverage for people who are 65 or older, or those who qualify due to a disability. It consists of two parts: Part A (Hospital Insurance) and Part B (Medical Insurance).
Part A covers inpatient hospital care, some home health care services, and hospice care. Part B covers physician services, outpatient hospital care, and certain preventive services such as annual physicals and screenings. It also covers some medical equipment such as walkers, wheelchairs, and oxygen. In order to be eligible for Original Medicare, you must be a U.S.
citizen or permanent resident who is 65 years of age or older, or you must have a qualifying disability. You can enroll in Original Medicare during your Initial Enrollment Period (IEP), which begins three months before you turn 65 and ends three months after you turn 65. You can also enroll during certain Special Enrollment Periods if you meet certain criteria. The cost of Original Medicare depends on the services you use. Part A has a monthly premium for most people, while Part B has a monthly premium that is determined by your income level.
In addition to the premiums, you are responsible for paying deductibles and copayments for the services you receive. Original Medicare does not cover all medical expenses. It does not cover prescription drugs, long-term care, or most dental care. If you want additional coverage for these services, you can purchase a Medicare Supplement insurance plan or enroll in a Medicare Advantage plan.
Medicare Supplement insurance plans help cover some of the expenses not covered by Original Medicare, such as deductibles and copayments. Medicare Advantage plans are private health plans that provide additional coverage beyond what Original Medicare covers, including prescription drug coverage and other benefits. It's important to understand what Original Medicare covers so that you can make an informed decision when it comes to enrolling in a plan. Knowing what is and isn't covered can help you decide if you need additional coverage and what type of coverage is best for your needs.
Ultimately, it's up to you to decide what type of coverage will best meet your needs and budget.
Additional Coverage OptionsWhen it comes to Original Medicare, you may want to consider additional coverage options. Two ways to get additional coverage are through a Medicare Supplement insurance plan or a Medicare Advantage plan.
Medicare Supplement Insurance Plans:Medicare Supplement insurance plans, also known as Medigap plans, are sold by private insurance companies and help pay for some of the out-of-pocket costs associated with Original Medicare. These plans can help cover copayments, coinsurance, and deductibles. There are 10 standardized plans available and each plan has its own set of benefits.
It’s important to note that you must have Original Medicare in order to be eligible for a Medigap plan.
Medicare Advantage Plans:Medicare Advantage plans, sometimes called Part C, are offered by private insurance companies and provide all of your Part A and Part B benefits. These plans may also include additional coverage like vision, hearing, dental, and more. You must have Original Medicare to be eligible for a Medicare Advantage plan.
What is Original Medicare?Original Medicare is the federal health insurance program that provides coverage for people who are 65 or older, or those who qualify due to a disability. Part A covers inpatient hospital care, skilled nursing facility care, hospice care, and some home health care services.
Part B covers medically necessary services and preventive services, such as doctor visits, lab tests, and preventive care. It also covers certain medical equipment and supplies. Eligibility for Original Medicare depends on age and disability. People who are 65 or older or those who qualify due to a disability are eligible for both Part A and Part B.
Those who are younger than 65 may be eligible for Part B if they have certain disabilities or end-stage renal disease. It also covers certain medical equipment and supplies.
How to Enroll in Original MedicareEnrolling in Original Medicare is easy and can be done online, by phone, or in person. It's important to understand when you can sign up for Original Medicare and when your coverage begins. Your initial enrollment period (IEP) is the seven-month window that begins three months before you turn 65 and ends three months after.
This is the time to sign up for Part A and Part B, which covers hospital and medical insurance, respectively. If you don't enroll in Parts A and B during your IEP, you may have to pay a late enrollment penalty, depending on your situation. You can apply for Original Medicare online through Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office. You will need to provide your Social Security number, dates of birth, and other basic information to apply. If you are already receiving Social Security benefits, you will automatically be enrolled in Parts A and B.
Once you have completed the enrollment process, your coverage will begin the first day of the month in which you turn 65 or the first day of the month after you enroll if it is later than that. If you are disabled and enroll during your IEP, your coverage will begin the 25th month after you become eligible.
Costs and CoverageOriginal Medicare includes both Part A (Hospital Insurance) and Part B (Medical Insurance). Each of these parts has its own premiums, deductibles, copayments, and coinsurance amounts.
Part A Premiums:Most people don’t have to pay a monthly premium for Part A because they or their spouse paid Medicare taxes while working.
However, if you weren’t eligible for premium-free Part A, you may be required to pay a monthly premium.
Part A Deductible:The Part A deductible is the amount you must pay for hospital services before Medicare begins to pay its share. In 2021, the Part A deductible is $1,484 per benefit period.
Part A Copayment/Coinsurance:Once the deductible is met, Medicare pays a certain percentage of the cost of covered services. For example, you may be responsible for paying a coinsurance amount of $371 per day for days 61–90 of a hospital stay.
Part B Premiums:The standard Part B premium in 2021 is $148.50 per month. Depending on your income, the premium may be higher.
Part B Deductible:In 2021, the Part B deductible is $203 per year.
Once you meet this deductible, you will generally pay 20% of the Medicare-approved amount for most doctor services.
Part B Copayment/Coinsurance:Medicare pays 80% of the Medicare-approved amount for covered services. You are responsible for paying the remaining 20%.
Coverage Limits:Original Medicare has some limits to coverage. For example, there is no coverage for long-term care or custodial care in nursing homes.
It also doesn’t cover routine dental care, hearing aids, or eyeglasses. Original Medicare is an important health insurance program that provides coverage for those who are 65 or older, or those who qualify due to a disability. While Original Medicare does provide essential coverage, it is important to explore additional coverage options such as Medicare Supplement insurance plans or Medicare Advantage plans, to ensure you have the right coverage for your needs. Enrollment in Original Medicare is easy and costs vary depending on factors such as income and location. In conclusion, Original Medicare can be an important source of coverage for those who are eligible.
To ensure you have the best possible coverage, it is important to explore additional options such as Medicare Supplement insurance plans or Medicare Advantage plans.