Original Medicare is a federal health insurance program for US citizens 65 years of age or older, or a person of any age with a qualifying disability. There are two parts: Part A & Part B.
Part A is hospital coverage while an inpatient in a hospital, skilled nursing facility care, hospice, and home health care.
What it costs - $0 if you have worked at least 10 years and have paid either Medicare taxes or self-employment, or are married to someone who has.
How it works – A hospital stay is charged a deductible of $1,364, covering the first 60 days.
Day 61-90 - $341 coinsurance per day of each benefit period
Days 91 and beyond : $682 coinsurance per each “lifetime reserve day” for each benefit period ( up to 60 days over your lifetime)
Beyond lifetime reserve days: all costs
Hole in coverage – Each hospital stay comes with a $1364 deductible. Example: If you go to the hospital in March, and then again in June, and once more in September each time you will pay the deductible.
Part B is medical coverage, or doctor visits outside of a hospital setting.
What is Costs – $135.50 monthly premium, as long as you are enrolled in Part B regardless of what Medicare products you sign up for.
How it Works – Coverage starts with an annual deductible of $185. After this deductible is met an 80/20 coinsurance takes effect with no stop loss.
Hole in coverage – If you incure $100,000 of medical expenses you owe $20,000 with no Max out –of –pocket.
Prescription Drug Coverage
There is NO prescription drug coverage in Original Medicare, which is another hole in coverage we must fill.
Remember Original Medicare is your main health insurance plan. Enrollment in both Part A and Part B is required in order to purchase any Medicare products to fill in the holes we mentioned.
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