Understanding Original Medicare Coverage

By Brian Krantz - March 22, 2023

At Plan Medicare, we know how important it is to make informed decisions about your healthcare coverage. That’s why we have prepared this guide to help you understand the basics of Original Medicare coverage, including what it covers, how much it costs, and how to enroll.

What is Original Medicare?

Original Medicare is a federal health insurance program that provides coverage for medical services and supplies to people who are 65 or older, as well as to some younger people with disabilities or specific health conditions. It consists of two parts:

  • Part A (Hospital Insurance): helps cover inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
  • Part B (Medical Insurance): helps cover doctor services, outpatient care, preventive services, and medical supplies.

What does Original Medicare cover?

Original Medicare covers a wide range of medical services and supplies that are medically necessary to diagnose or treat a health condition. Some examples include:

  • Doctor visits, including specialists
  • Laboratory tests and X-rays
  • Emergency room visits
  • Hospital stays
  • Surgery and anesthesia
  • Home health services
  • Hospice care
  • Medical equipment and supplies
  • Preventive services, such as flu shots and cancer screenings

What are the costs of Original Medicare?

Most people don’t have to pay a premium for Part A, but there are deductibles, coinsurance, and copayments for some services. Part B has a monthly premium, which varies depending on your income, and also has deductibles, coinsurance, and copayments.

It’s important to note that Original Medicare does not cover all healthcare expenses, and there may be gaps in coverage that you will have to pay for out of pocket or with supplemental insurance.

How do I enroll in Original Medicare?

If you are receiving Social Security or Railroad Retirement Board benefits, you will be automatically enrolled in Original Medicare when you turn 65. If you are not receiving these benefits, you will need to enroll yourself during your Initial Enrollment Period, which starts three months before your 65th birthday and ends three months after.

You can enroll in Original Medicare through the Social Security Administration website, by calling their toll-free number, or by visiting a Social Security office. If you want to enroll in a Medicare Advantage plan or a Medicare Supplement Insurance (Medigap) plan, you will need to do so separately through a local New York Medicare agent like the specialists at Plan Medicare.

In conclusion, Original Medicare is a valuable healthcare coverage option for many older Americans and those with disabilities or specific health conditions. It provides coverage for a wide range of medical services and supplies, but it’s important to understand the costs and limitations of this coverage.

At Plan Medicare, we are committed to helping you make informed decisions about your healthcare coverage. If you have any questions about Original Medicare or any other Medicare-related topics, please don’t hesitate to contact us.


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