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Original Medicare Program

Original Medicare is made up by Medicare Part A and Medicare Part B. Original Medicare is managed by the federal government and provides Medicare eligible individuals with coverage and access to doctors, hospitals, or other health care providers who accepts Medicare. It is a fee-for-service plan, meaning that the person with Medicare usually pays a fee for each service. Medicare pays its share of an approved amount up to certain limits, and the person with Medicare pays the rest.

MEDICARE PART A:


Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.


Most of the time Part A doesn't cost you anything in terms of monthly premium as long as you have paid 40 quarters in the the Medicare system through taxes while you were working.


If you aren't eligible for premium-free Part A, you may be able to buy Part A. You'll pay up to $505 each month in 2024. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $505. If you paid Medicare taxes for 30–39 quarters, the standard Part A premium is $278.


MEDICARE PART B:


Medicare Part B covers 2 types of services -

*Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.

* Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best. is outpatient medical coverage.


Visits to your primary care physician, specialists, surgeries, lab work, and preventative services are all covered under Part B. There is a monthly premium that you would be responsible for, that will be withdrawn directly from your Social Security check if you are drawing Social Security. Otherwise you would need to pay the premium 3 months at a time from your checking account.


There is a once a year deductible that you would have to meet before Part B pays anything, then it is a 80/20 split where you would be responsible for 20% of the costs of service.


MEDICARE PART C:


Medicare Part C is also called Medicare Advantage (MA or MAPD). It’s an alternative to Original Medicare. Medicare Advantage may include prescription drug coverage, along with other extra benefits. It is offered through private insurance companies, so you don’t enroll in it at the Social Security office or website. These are usually network plans such as HMO's and PPO's with copayments and coinsurance found all throughout the plan based on services rendered. If you have an MA plan then this becomes your Primary Insurance and Original Medicare gets set aside but you will still need to continue paying your Part B premiums.


MEDICARE PART D:


Medicare Part D is your prescription drug coverage. Part D coverage is available as a Stand Alone Option (PDP) or as part of a Medicare Advantage plan (Part C). Part D plans are offered by private insurance companies contracted and approved by Medicare and it is mandatory that you have credible drug coverage when you join Original Medicare or if you choose a Medicare Advantage plan.


To learn more about the options of having Original Medicare with a Supplement and Drug Plan OR choosing a Medicare Advantage plan, please click one of the buttons below. You can also always press the "Click to Call" button above to reach us today!

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