| Tue, Jul 03, 2012 @ 09:00 AM

What is Original Medicare?

Posted by Medicare Made Clear

What is Original Medicare?Original Medicare is health insurance that the U.S. federal government provides to almost 50 million Americans, according to the Kaiser Family Foundation. Medicare first became law when President Lyndon B. Johnson signed the United States Social Security Act Amendments on July 30, 1965. Original Medicare is made up of Medicare Part A and Medicare Part B.

When you’re first learning about Medicare, it can be difficult to keep all the details straight. Learning the basics of Original Medicare is a good place to begin.

What does Original Medicare cover?

Medicare Part A covers medically necessary care provided in the hospital. It also helps pay for care in a skilled nursing Nursing care that should be provided only by a licensed nurse. facility as a follow-up to a hospital stay. Along with medical and nursing care, Medicare Part A also covers inpatient meals, operating and recovery room services, lab tests, medications, x-rays, blood transfusions and more. Lastly, Part A covers hospice care for the terminally ill, and some skilled home health careIn Original Medicare, skilled nursing care and therapy, such as speech therapy or physical therapy, provided on a part-time or intermittent basis to those who cannot leave the hom.

Medicare Part B covers medically necessary outpatient care. This includes doctors’ office visits, outpatient surgery and emergency room services. It also covers skilled nursing care, medical equipment, certain diagnostic screenings and more. Medicare Part B also pays for most doctor services you receive as a patient in the hospital, though other hospital services are covered by Part A. And to help keep you healthy, Medicare Part B covers some preventive care. This includes Care that is meant to keep you healthy, or to find illness early, when treatment is most effective. Examples of preventive care are flu shots, screening mammograms and diabetes screeninan annual physical exam, and certain immunizations (shots) and screenings.

Who can sign up for Original Medicare? How do the costs work?

Both Medicare Parts A and B are primarily for people who are 65 or older. Some people qualify for Medicare before they’re 65 because of a disability or because they have End-Stage Renal Disease. For more information on Medicare eligibility, see the official U.S. government Medicare handbook, Medicare & You 2012.

 

The premiums you pay for Original Medicare depend upon your work history and your income.

  • Medicare Part A is premium free if you or your spouse have worked and made payroll contributions to Social Security for at least 10 years (40 quarters). If you otherwise qualify for Medicare but neither you nor your spouse contributed to Social Security for at least 10 years, you pay a monthly premium.

  • However, unlike Part A, most people pay a monthly premium for Medicare Part B. The premium amount depends on your yearly income.

Both Medicare Parts A and B involve other costs for most recipients of Original Medicare. These “out-of-pocket” costs include an annual deductible, and copays coinsurance on care and services. See the Medicare Made Clear website for more detailed information on costs for Medicare Part A and Medicare Part B.

Which doctors can you see with Original Medicare?

For both Medicare Parts A and B, you can choose any qualified health care provider in the U.S. who has been accepted by Medicare and who is accepting new patients. Medicare Part A offers the same benefits throughout the U.S. That means that you’re not limited by geography for where you can get care.

For more information, contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. If you have questions about Medicare Made Clear, call 1-877-619-5582, TTY 711, 8 a.m. – 8 p.m. local time, seven days a week.

Resources:

Getting Started: Medicare Basics – MedicareMadeClear.com

Medicare Made Clear Answer Guide – MedicareMadeClear.com

Your Medicare Benefits – Medicare.gov

 

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