What is Original Medicare?

You may have heard the term Original Medicare, Part A, Part B and so many other terms for Medicare. There are a lot and yes it can get confusing in a hurry.

Let’s go through what Original Medicare is and a little on how it works.

Original Medicare has two parts:

  • Medicare Part A Hospital Insurance
  • Medicare Part B Medical Insurance

Medicare Part A coverage includes:

  • Inpatient Hospital Care
  • Limited Home Health Care
  • Skilled Nursing Facility Care
  • Hospice Care

*There are deductibles and coinsurance you may be responsible for in 2020. See chart below.

Medicare Part B will have a monthly premium. Your premium will be determined by your yearly income. See chart below.

This chart below shows how the Part B premium could be affected based on income amounts.

Medicare Part B Coverage includes:

  • Office Visits
  • Surgeons
  • R. Urgent Care
  • Radiology Labs
  • Ambulance Services

*There are deductibles and coinsurance you may be responsible for in 2020. See chart below.

On all Medicare-covered expenses, a doctor or other health care provider may agree to accept Medicare “assignment”. This means the patient will not be required to pay any of the expenses in excess of Medicare’s “approved” charge. The patient pays only 20% of the “approved” charge not paid by Medicare.

Physicians who do not accept assignment of a Medicare claim are limited as to the amount they can charge for the covered services. In 2006, the most a physician can charge for services covered by Medicare is 115% of the fee schedule amount for non-participating physicians.

This is what is called Original Medicare. This is what everyone has when they are on Medicare and it works this way for all people who have Medicare Part A and Medicare Part B.

You may be wondering why you hear people, see commercials, or have read about Medicare Supplements, Medicare Advantage (Part C), Prescription Drug Rx (Part D) and much more.

That is correct and we will cover those briefly in the next post so stay tuned!

Wrapping it Up

Medicare Part A is Hospital Insurance and Medicare Part B is Medical Insurance.

When you are looking to retire or disabled you can participate in Original Medicare through your social security benefits. Once you have enrolled in these plans you can then enroll in the private coverages available in your area.

Click Link to learn more about Medicare Part A


Click Link to Learn more about Medicare Part B


Medicare & You 2020