Original Medicare

Original Medicare is the traditional fee-for-service health insurance program offered directly by the federal government. It consists of two main parts:

• Medicare Part A: Hospital insurance covering inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
• Medicare Part B: Medical insurance covering outpatient services, doctor visits, preventive care, durable medical equipment, and some home health care.

Most people aged 65 and older are eligible for Original Medicare if they are citizens or permanent residents of the United States and meet certain residency requirements. Moreover, individuals under 65 with specific disabilities or medical conditions may also be eligible for Medicare.

While most people do not pay a premium for Medicare Part A (if they or their spouse have paid Medicare taxes while working), there is typically a monthly premium for Medicare Part B. The amount of the Part B premium may vary depending on income level and whether you’re enrolling during your Initial Enrollment Period or a Special Enrollment Period.

Yes, Original Medicare has out-of-pocket costs such as deductibles, copayments, and coinsurance. For example, Medicare Part A has a deductible for each benefit period, and Medicare Part B typically requires you to pay 20% of the Medicare-approved amount for most services after you meet your annual deductible.

Yes, many beneficiaries choose to supplement Original Medicare with additional coverage options to help cover out-of-pocket costs and services not included in Parts A and B. This can include purchasing a Medicare Supplement Insurance (Medigap) policy to help pay for certain costs like deductibles and copayments, or enrolling in a Medicare Part D prescription drug plan to add prescription drug coverage. Additionally, some beneficiaries opt for Medicare Advantage plans, which combine Parts A and B coverage with additional benefits like prescription drug coverage, dental, vision, and hearing coverage, and wellness programs.