What is Original Medicare?

What is Original Medicare?
Original Medicare refers to Medicare Part A and Part B, both of which will be explained in further detail below.

Medicare Part A 

Medicare Part A covers many hospital services and supplies. It includes expenses incurred during stays at the following hospital settings: 
  • Inpatient hospital
  • Skilled nursing facility
  • Hospice care
  • Home health services

Part A Premiums

Most often, individuals do not pay a premium for Medicare Part A. You can avoid paying a premium if the following conditions are true:
  • You are age 65 or older.
  • You or your spouse worked and paid Medicare taxes for at least 40 quarters (10 years).

Keep in mind other Part A expenses including deductibles, copayments and coinsurance.

Medicare Part B

Medicare Part B covers medical services and supplies outside of a hospital setting. This coverage includes:
  • Doctor appointments
  • Laboratory tests
  • X-rays
  • Emergency ambulance transportation
  • Preventive tests
  • Durable medical equipment

Medicare Part B Premium

Though the cost varies according to plan and income, most people do pay a premium for Medicare Part B.

Medicare Part B Deductible and Coinsurance

Part B includes an annual deductible and coinsurance. Prior to reaching your deductible, payment for a medical service or supply will fall into one of the following three categories:
  • You will be responsible for paying the full Medicare-approved cost of most services or supplies that Medicare approves and the cost will apply to your deductible.
  • Some services or supplies have no deductible won't cost you anything, for example the flu shot.

After you have met your deductible, you will be responsible for paying coinsurance, often 20% of the Medicare-approved amount for a service or supply. At the end of a year, the deductible and coinsurance are reset.

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What is Original Medicare?