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Original Medicare

Original Medicare is made up of Part A (Hospital Insurance) and Part B (Medical Insurance). These benefits are administered by the federal government.

Some individuals are automatically enrolled if they are receiving Social Security benefits, while others need to sign up as they approach age 65.

Medicare Part A

Hospital Insurance

Part A helps cover inpatient hospital care, skilled nursing facility care, certain home health services, and hospice care.

Key Points:

Most people do not pay a premium for Part A if they or their spouse worked and paid Medicare taxes for at least 10 years.

Cost-sharing may apply for extended hospital stays or skilled nursing care.

Coverage can be used at hospitals across the United States that accept Medicare.

Costs Associated With Part A

- Deductible: A deductible must be met before Medicare Part A begins to cover eligible services.

- Premiums: Many individuals do not pay a premium for Part A if they or their spouse paid Medicare taxes for at least 10 years. Those who do not meet this requirement may be able to purchase Part A coverage.

- Copayments and Coinsurance: Cost-sharing may apply for extended hospital or skilled nursing facility stays.

- Inpatient hospital care: coinsurance applies after day 60 of a benefit period.

- Skilled nursing facility care: coinsurance applies after day 20 of a benefit period.

-Inpatient mental health care: coinsurance applies after day 60 of a benefit period.

Note: Medicare coverage is generally accepted nationwide, as most hospitals in the United States participate in the program.

Medicare Part B

Medical Insurance

Part B helps cover services such as doctor visits, outpatient care, preventive services, and medical equipment.

Key Points:

Most people pay a monthly premium for Part B.

Cost-sharing (such as coinsurance or copayments) may apply for certain services.

Preventive services like annual wellness visits and screenings are generally covered at no cost when certain conditions are met.

You can see any provider in the U.S. that accepts Medicare patients.

Costs Associated With Part B

- Premiums: Part B requires a monthly premium, which is based on income and enrollment timing. Most enrollees have their premium deducted from Social Security benefits.

- Deductible: A deductible must be met each year before Part B coverage begins.

- Coinsurance and Copayments: Typically, beneficiaries are responsible for 20% of the Medicare-approved amount for covered services if the provider accepts assignment.
- Preventive Care: Many preventive services, such as screenings and annual wellness visits, are covered at no cost to the beneficiary.

Additional Information:

- Coverage is generally available throughout the United States with any doctor or provider who accepts Medicare.

- Part B premiums, deductibles, and coinsurance amounts may change annually, with updates typically effective on January 1.

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Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to the plans we represent. For information on all options, please visit Medicare.gov or call 1-800-MEDICARE.

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NPN:

Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to the plans we represent. For information on all options, please visit Medicare.gov or call 1-800-MEDICARE.