Original Medicare

Introduction to Medicare

What is it?

Medicare also commonly referred to as Original Medicare is the Federal health insurance program for individuals who are aged 65 or older. It is also available to individuals younger than 65 with qualifying disabilities or End-Stage Renal Disease (ESRD). The Medicare program is overseen by the Centers for Medicare & Medicaid Services (CMS) and is funded through Social Security and Medicare taxes you pay on your income. Medicare comprises of two components tailored to cover inpatient hospital stays and doctors' services. Medicare Part A provides coverage for inpatient hospital coverage and Medicare Part B provides coverage for outpatient medical coverage. Explore further details about the Medicare program in the sections below

Medicare Part A

Inpatient Hospital Coverage

Medicare Part A, often referred to as hospital insurance, covers inpatient hospital stays, skilled nursing facility care, hospital care, and some home health care. It's generally available without a premium for people who have worked and paid into Medicare taxes for 40 quarters. However, there may be costs such as deductibles, coinsurance, and copayments associated with specific services. Part A helps cover medically necessary services including surgeries, lab tests, and doctors visits during a hospital stay. It is important to understand that Part A does not cover services such as long-term care, routine dental, and eye exams related to prescribing glasses, or cosmetic surgery. Enrolling in Part A is typically automatic if you are receiving Social Security or Railroad Retirement Board benefits. However, if you are not automatically enrolled, you will need to manually enroll during your Initial Enrollment Period (IEP).

Medicare Part B

Outpatient Medical Coverage

Medicare Part B, often referred to as outpatient Medicare insurance, covers outpatient care such as doctor's visits, specialist consultations, and outpatient procedures. Preventive services like screenings for cancer, cardiovascular disease, and diabetes are also covered, aiming to detect health issues early for effective intervention. Part B extends coverage to durable medical equipment like wheelchairs, walkers, and oxygen equipment, facilitating improved mobility and quality of life for beneficiaries. Additionally, it encompasses certain vaccinations, ambulance services, and mental health services, ensuring comprehensive care for Medicare enrollees. Opting out of Medicare Part B is generally not advisable unless you have insurance coverage through your own or your spouse's employer- sponsored insurance plan. It is important to note that while enrolling in Part B coverage is optional, enrolling during the initial enrollment period can avoid potential late penalties. Part B also often requires coinsurance or copayments for covered services, though certain preventative services are offered at no cost to the beneficiary.

What Original Medicare does NOT cover?

"The Gaps"

Original Medicare, comprising Part A and B, covers a lot of your healthcare costs but it does NOT cover everything. You will have to pay deductibles, copays, and coinsurance. Additionally, Original Medicare lacks coverage for vision, dental, and prescription drugs. However, there are available alternative coverage options to help bridge these gaps that Original Medicare doesn't. If you need help contact us and we can help you navigate through your coverage options.

Need assistance? Contact us to speak to a Licensed Insurance Agent?

Seniority Insurance Group, LLC is a non-government entity, a health insurance agency. We do not offer every plan available in your area. Currently we represent 7 organizations which offer 40 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. We represent Medicare Advantage [HMO, PPO, and PFFS] organizations and stand-alone PDP prescription drug plans that have a Medicare contract. Enrollment depends on the plan’s contract renewal. Extra benefits require enrollment in an MA plan and depend on whether you are eligible to enroll in an MA plan in your area. Benefits are available only in select areas.

Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease.

The purpose of this communication is the solicitation of Insurance. Contact will be made by an insurance agent/producer of insurance company.

Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.