What Does Original Medicare Cover?
Medicare is a health insurance program available to certain people age 65 or older and to younger people with certain disabilities. The people it covers include:
Adults age 65 or older
Younger people with disabilities
Children with disabilities
People with permanent kidney failure
People with Lou Gehrig's disease
People with end-stage renal disease
People who need a kidney transplant
Read more about Medicare eligibility and who is covered.
Original Medicare includes the following parts:
Part A – Hospital insurance
Part B – Medical insurance
Part C – Medicare Advantage private health plans
Part D – Prescription drug coverage
Medicare Part A (hospital insurance)
Part A is free hospital insurance for people with Medicare. It helps pay for inpatient hospital care, skilled nursing facility care, home health care, hospice care, and some home health services. Under Part A, Medicare also pays some costs for some people who are in a hospital paid for under Part B.
Part B (medical insurance)
Part B is optional medical insurance for people with Medicare. It helps pay for doctors' services, outpatient hospital care, medical equipment, and other services. Part B also helps cover some of the costs of the health care services that are covered under Part A.
Part B is often called "Medical Insurance" or "Medigap."
Part C (Medicare Advantage private health plans)
Medicare Part C plans are also known as Medicare Advantage plans. These are health insurance plans offered by insurance companies. They are approved by Medicare but are not run by Medicare. They may be HMOs or PPOs.
Medicare Part C plans must provide at least the same benefits as the regular Medicare program. These plans can include prescription drug coverage and extra benefits like vision, dental, and hearing. People who pick a Part C plan can choose to stay in the plan or switch to Original Medicare.
Part D prescription drug coverage
Medicare Part D is prescription drug coverage. It covers prescription medications and is another optional benefit for people with Medicare. People with Medicare can choose to enroll in a Part D plan to get prescription drug coverage.
Part D plans are run by private companies approved by Medicare. They cover some of the costs of prescription drugs, and people pay the rest.
How can I get original medicare?
To get original Medicare, you have to be eligible and sign up. Take a look at eligibility requirements.
Starting Jan. 1, 2011, people with Medicare can sign up for original Medicare whenever they want during the year and not just during the Medicare open enrollment period (Oct. 15–Dec. 7). This is true no matter what your age, whether or not you have or had other health coverage, and whether you or your spouse has lost employer-sponsored health insurance.
It's important to understand that signing up for Part A doesn't automatically enroll you in Part B. You must sign up for Part B separately.
Who can get original Medicare?
Medicare is free for most people who get it. People pay monthly premiums for Part B. Some people with high incomes pay a higher premium. People who are eligible for both Medicare and Medicaid pay nothing for Part A.
People with certain disabilities can get extra help paying their Part B and Part D premiums.
How do I enroll in original medicare?
You have several options for signing up for Original Medicare:
You can enroll online at: www.Medicare.gov You can sign up by phone at: 1-800-MEDICARE (1-877-690-1012) You can sign up in person: at a Social Security office,
by calling Social Security at 1-877-690-1012, or
by going to www.socialsecurity.gov/local. If you are deaf or hard of hearing, you can call Social Security at TTY 1-877-690-1012. You can enroll in person at a Medicare retail clinic.
When you sign up for Part A, you will have to pay a premium for Part A and for Part B. The Part B premium is $104.90 per month in 2016, unless you are eligible for extra help paying your premium.
You may also have to pay a deductible for Part A.
If you get premium-free Part A, you may have to pay a deductible for Part B.
You will also be able to sign up for Part C (Medicare Advantage), Part D (prescription drug coverage), or both.
How do I pay for original medicare?
Most of the time, you pay your Part B premium through the payroll system (through your employer or former employer).
If you don't have Part B and you need it to get Part A, you may have to pay for it. The Part B monthly premium is $104.90 in 2016, unless you are eligible for extra help paying your premium.
Part A has a deductible. This means you may have to pay the full cost of your care until you have paid the deductible.
If you have Part C, you may also have to pay a deductible for Part A.
And if you get premium-free Part A, you may have to pay a deductible for Part B.
How does original medicare work?
Medicare is a national health insurance program for people who are 65 or older, for younger people who have disabilities, and for people with permanent kidney failure. It is available to anyone who qualifies. Eligibility rules are set by law (Medicare law), but they are modified by regulations (Medicare regulations) issued by the Centers for Medicare and Medicaid Services (CMS).
In general, Medicare has four components: hospital insurance, medical insurance, prescription drug coverage, and additional insurance options.
Part A (Hospital Insurance)
Part A is free hospital insurance for people with