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What is Original Medicare?


Original Medicare is a fee-for-service health insurance program for people over the age of 65. It is also available to people with certain disabilities under the age of 65. Original Medicare has two parts:

  • Part A (Hospital Insurance) covers inpatient hospital stays, skilled nursing facility care, some home health care, and end-of-life hospice care.

  • Part B (Medical Insurance) covers doctor visits, outpatient services, medical supplies, and preventive care.

Original Medicare covers most medically necessary services and supplies, but it doesn't cover everything. For example, it doesn't cover prescription drugs, long-term care, or dental and vision care. Who is eligible for Original Medicare? To be eligible for Original Medicare, you must be:

  • Age 65 or older, or

  • Under the age of 65 with a disability that meets Social Security Administration (SSA) requirements, or

  • Under the age of 65 with end-stage renal disease (ESRD).

How does Original Medicare work? Original Medicare is a fee-for-service program, which means that you pay a deductible and coinsurance for each covered service. You may also have to pay a premium for Part B. Here's a general overview of how Original Medicare works:

  1. You pay a deductible before Medicare starts to pay its share.

  2. Medicare pays its share of the Medicare-approved amount for the covered service.

  3. You pay your share of the cost, which is called coinsurance.

How much does Original Medicare cost? The cost of Original Medicare depends on your income and whether you choose to purchase supplemental coverage.

  • Part A is free for most people. If you worked and paid Medicare taxes for at least 40 quarters, you won't have to pay a premium for Part A. If you didn't work long enough, you may have to pay a monthly premium for Part A.

  • Part B has a monthly premium. The standard Part B premium for 2023 is $164.90. However, your premium may be higher or lower depending on your income.

You can also purchase supplemental coverage, such as Medigap or Medicare Advantage, to help pay for your out-of-pocket costs under Original Medicare. How to enroll in Original Medicare If you are already receiving Social Security benefits, you will automatically be enrolled in Part A when you turn 65. You will need to enroll in Part B if you want it. If you are not receiving Social Security benefits, you can enroll in Original Medicare during your Initial Enrollment Period (IEP). Your IEP begins three months before the month of your 65th birthday and ends three months after the month of your 65th birthday.

Conclusion Original Medicare is a good option for many people, but it's important to understand how it works and what it costs before you enroll. You may also want to consider purchasing supplemental coverage to help pay for your out-of-pocket costs.

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