What is Original Medicare?

March 01, 2024

  • Original Medicare is the traditional form of Medicare offered by the federal government. It consists of two main parts:
    • Part A (Hospital Insurance): Covers hospital stays, skilled nursing facility care, some home health care, and hospice care.
    • Part B (Medical Insurance): Covers doctor visits, outpatient care, medical supplies, and preventive services.

How Does It Work?

  • Costs:
    • You'll usually pay a monthly premium for Part B. The amount can change yearly.
    • You also have deductibles (the amount you pay before Medicare kicks in) and coinsurance (a percentage of the cost you pay) for services under both Part A and Part B.
    • There's no limit to your out-of-pocket costs with Original Medicare.
  • No Networks: One of the key benefits of Original Medicare is the freedom to see any doctor or hospital that accepts Medicare (which is the vast majority in the U.S.)
  • Claims: In most cases, your healthcare providers will file claims directly with Medicare, so you don't have to worry about paperwork.

Additional Considerations

  • Prescription Drugs: Original Medicare doesn't cover most prescription drugs. You'll need to purchase a separate Medicare Part D (prescription drug) plan.
  • Supplemental Coverage: To help with out-of-pocket costs, many people choose to buy a Medicare Supplement Insurance (Medigap) policy. These private plans help cover some of the expenses that Original Medicare doesn't.

Key Points to Remember:

  • Original Medicare offers flexibility in choosing healthcare providers.
  • You'll likely face out-of-pocket costs like deductibles and coinsurance.
  • You'll need additional coverage for prescription drugs and to help limit out-of-pocket expenses.