If you’re soon-to-be eligible for Medicare, you’re probably wondering what Original Medicare is. Whether you’re preparing to retire or about to celebrate your 65th birthday, you’ll need to make decisions about your Medicare soon. Not only are there dozens of plans and coverage types, but Medicare has unique terminology. Below, we provide you with the information needed to understand what Original Medicare is and how your benefits work.
What is Original Medicare?
Original Medicare provides healthcare coverage to eligible beneficiaries for both inpatient and outpatient services. Original Medicare is a fee-for-service plan that’s managed by the federal government.
Medicare Part A vs Part B
Part A is your inpatient coverage. So, a hospital visit or hospice care would fall under Part A. For many people, Part A is premium-free, but some pay for this coverage. The premium depends on how long you’ve contributed to Medicare taxes.
Medicare only covers 80% of Part A services after you’ve met the deductible. A new benefit period starts when you’ve been out of an inpatient facility for 60 days or more. Part B is the outpatient portion of Medicare. You’ll use Part B at doctors’ offices.
While Part A is premium-free, Part B has a monthly premium based on income. For outpatient services, Medicare covers 80% after you meet the annual deductible. The Part B deductible is a once-per-year amount.
What Are the Qualifications for Medicare?
If you’re turning 65 or have been on disability for at least 24 months, you’re likely eligible for Medicare. Those with Amyotrophic Lateral Sclerosis or End-Stage Renal Disease may not need to wait 24 months for Medicare to start.
How to Enroll in Original Medicare
You’ll be enrolling in Medicare through Social Security. You can apply for Medicare via phone, online through the Social Security website, or in person.
Generally, you can pick one of these three periods to enroll:
- Initial Enrollment Period: This occurs when the beneficiary turns 65.
- Special Enrollment Period: Qualifying life events that allow you to make changes to your Medicare coverage.
- General Enrollment Period: Runs from January 1 to March 31 annually. During this time, you may sign up if you didn’t do so during your Initial Enrollment Period. Delaying Part B enrollment will result in a late enrollment penalty.
Understanding Medicare Premiums
Many people think that Medicare is free. In reality, you’ll likely pay a monthly premium for coverage. Though Part A is free for most people, most people also pay a standard premium for Part B. You may pay more if your income is above a certain amount. The cost of Medicare depends on your specific situation; income, plan choice, and applicable late enrollment fees.
How to Get Help Understanding Original Medicare
We hope the above information was helpful. We're here as a resource to help you better understand all aspects of Medicare. Original Medicare doesn't cover everything. Part A and Part B both leave 20% of costs uncovered for you to pay out-of-pocket.
However, Medicare Supplement or Medigap plan will pay for what Medicare doesn’t. To find out more about Medicare Supplements, call the number above.
One of our agents will ask you a series of questions to better identify your policy match. Then, they can compare all the top-rated carriers in your service area to find the best option. You’ll see why many seniors trust us with their insurance needs.
We have your back long after enrollment. Our Client Care Team ensures our customers have a great experience for years to come. We can answer all your Medicare questions. If calling now isn’t an option, fill out our online rate form to start the process. An agent will be in contact with you to provide free expert advice.