| Thu, Sep 29, 2016 @ 09:00 AM

What is Original Medicare?

Posted by Medicare Made Clear

how-does-original-medicare-help-seniorsWhen it comes time to sign up for Medicare, you have a lot of options to choose from. The most basic option is Original Medicare. But what does that include?

Original Medicare is a federal health insurance program and has two parts, Part A and Part B. Each part covers different aspects of your health care needs.

Medicare Part A

In general, Medicare Part A covers the cost of your care when you have to stay in the hospital. This usually includes

  • a semi-private room
  • meals
  • nursing care
  • tests
  • drugs
  • other services and supplies when you’re admitted to the hospital for an illness or surgery

Part A does not help pay for personal care in the hospital, such as help with eating, bathing or dressing, or personal services such as the cost of a phone or TV. Physician services in the hospital are generally covered by Part B.

You may have to pay a deductible of $1,288 per benefit period in 2016 for your hospital stay. After that, Part A pays most of the cost up to a 60-day stay. If you’re in the hospital for longer than 60 days, you may pay a larger share of the cost.

Part A also helps pay for care received in a skilled nursing facility and through home or hospice care.

If you’re discharged from the hospital or skilled nursing facility and then have to be readmitted within 60 days, it’s covered under the same deductible. If it’s been more than 60 days since your discharge, you may have to pay a new deductible.

Medicare Part A is usually “premium free” if you or your spouse contributed to Medicare through payroll deductions for at least 10 years.

Medicare Part B

Medicare Part B covers

  • doctor visits and doctor services in the hospital
  • outpatient care
  • some preventive services
  • ambulance services
  • mental health care
  • durable medical equipment (such as wheelchairs, walkers, blood sugar monitors, etc.) as prescribed by your doctor

Part B charges a monthly premium based on your yearly income. In 2016, premiums range from $121.80 to $389.80 per month for new enrollees. You may also pay an annual deductible ($166 in 2016) and coinsurance equaling 20% of the cost for most of your care.

Conclusion

Original Medicare doesn’t cover everything. If you need more coverage than Original Medicare alone provides, you can look into adding a Medicare Supplement insurance plan and a Medicare Part D (prescription drug) plan. Or you may want to sign up for a Medicare Advantage plan instead, which provides your Part A and Part B coverage and usually includes drug coverage. Most plans also offer extra benefits such as coverage for dental, vision and hearing care. You can buy these plans through private companies approved by Medicare. Look for plans offered where you live at Medicare.gov.

Related Content

Guide to Original Medicare (Part A and Part B) (video)

Medicare: How to Put the Parts Together

Get Help Managing Out-of-Pocket Medicare Costs

 

For more information, explore MedicareMadeClear.com or 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.

 

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