Original Medicare
Original Medicare is the federal health insurance program primarily for individuals aged 65 and older, as well as certain younger individuals with disabilities or specific medical conditions like End-Stage Renal Disease (ESRD).
Part A: Hospital Insurance
- Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care services.
- Most people don’t pay a premium for Part A if they or their spouse paid Medicare taxes while working (typically requires 40 quarters of work).
- You may have to pay deductibles, coinsurance, or copayments depending on the type of care you receive.
Part B: Medical Insurance
- Covers outpatient services, such as doctor visits, preventive services, durable medical equipment (like wheelchairs), and some home health care.
- Part B has a monthly premium (which can vary based on income), and you pay an annual deductible as well as a coinsurance (typically 20% of the Medicare-approved amount for most services).
- There is no coverage for routine dental, vision, or hearing care under Part B.
Original Medicare generally gives you a lot of flexibility in choosing healthcare providers, but it doesn’t cover all healthcare costs. Beneficiaries are responsible for some out-of-pocket costs, such as premiums, deductibles, and coinsurance.
Limitations of Original Medicare:
- No coverage for prescription drugs (unless you have Medicare Part D).
- No coverage for routine dental, vision, or hearing care.
- No limit on out-of-pocket costs, meaning you may end up paying a significant amount for care.