How Original Medicare Works

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Medicare

Often called Original Medicare, the most basic level of coverage you can obtain includes two separate parts. Individuals are eligible for this plan once they turn 65 or if they are disabled or have a qualifying medical condition. In many cases, as long as you are enrolled in Social Security or Railroad Retirement Board retirement benefits, you will automatically begin receiving Medicare coverage.

While many options are available based on your specific needs, Original Medicare does do a sufficient job in covering both hospital expenses and routine medical costs. Not all services will be paid for in full, but as long as you visit a provider that accepts Medicare, the plan will pay at least a portion of the total expense. Let’s take a closer look at exactly what basic Medicare coverage entails.

A Two-Part Plan

 Original Medicare is composed of two sections called Part A and Part B. In many cases, these plans are comprehensive enough to meet a person’s basic medical needs, although for more coverage or specific health concerns, additional plans may be purchased to supplement Original Medicare. While everyone who is eligible typically has coverage under Part A, an individual can choose to opt out of Part B if they so desire.

Exploring Part A

 It’s comforting to know that no matter what happens in life, you will have some level of medical coverage once you turn 65 through Medicare Part A. This plan is referred to as hospital coverage as it will help to pay toward the cost of inpatient care, hospice services, skilled nursing facility care, and in some cases, various aspects of home health care. The details of coverage are quite specific, so it’s best to have a full understanding of your benefits to ensure you aren’t surprised with a bill later on.

Acute care hospitals, mental health care, and critical access facilities are all contracted to work with Medicare Part A, and many aspects of your visit will be paid for including a semi-private room, meals, and medications that are a part of your treatment plan. Personal care items and superfluous charges are usually not covered by Medicare.

What Part B Entails

 When you think of medical coverage, one of the major aspects to consider are the costs associated with more regular and routine care. Visiting your doctor, receiving preventative services, and having lab work done are all elements that may be covered under Medicare Part B. As with all Medicare plans, these services will only be eligible for payment if they are rendered by a Medicare provider.

Medicare Part B coverage does typically involve paying a monthly premium that is calculated based on your annual income. Both elements of Original Medicare may include copays, deductibles, and specific coverage limits, so make sure that you fully understand your policy before obtaining medical care.

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