What is Original Medicare

Original Medicare, or Medicare Parts A and B, make up the two public health insurance options provided by the government since President Lyndon B. Johnson created the program in 1964. Original Medicare was considered so successful that it remained unchanged for decades.

Today, Parts A and B continue to cover many of the health costs for millions of Medicare enrollees. How does Original Medicare succeed in this, and what do the parts cover?

Medicare Part A

Medicare Part A can be thought of as a beneficiary’s hospital insurance. It helps to pay for their stay at a health care facility, whether that be a hospital, skilled nursing facility, or nursing home, among others.

At these inpatient facilities, Part A covers many of the services, including meals, a semi-private room, prescription drugs taken during a beneficiary’s treatment, and mental health care. Private nursing or rooms are not covered unless determined to be medically necessary.

In some circumstances, Part A can assist with services like hospice or home health care. Beneficiaries should contact their doctor to see if they fall into a qualifying category.

Most Americans are automatically eligible for Medicare Part A when they turn 65. They can also receive the benefit premium-free in most circumstances.

Medicare Part B

Medicare Part B covers medically necessary services, including doctor visits, ambulance services, and physical therapy. Part B covers many preventive and screening services, as well.

If a beneficiary needs any durable medical equipment, Part B can help them pay for it. A durable medical equipment is an item that their primary care physician prescribes to them to use at home. This includes items like wheelchairs, blood sugar monitors, or hospital beds. It must be:

  • Able to withstand repeated use, lasting for at least 3 years;
  • Used for medical reasons;
  • Generally, not useful to someone who isn’t ill or injured;
  • Used in their home

Unlike Medicare Part A, all enrollees must pay a monthly premium for Part B. If a beneficiary receives Social Security or similar benefits, these premiums come out of their benefit payment. In most cases, Medicare enrollees will pay a standard premium.

Thanks to Parts A and B, millions of seniors can afford the health services and supplies they need. To learn more about what Original Medicare covers, visit Medicare.gov.

Further Reading:

Medicare.gov | What Part A covers Medicare.gov | What Part B covers Medicare.gov | Signing up for Part A & Part B

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