What Does Original Medicare Cover?
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Medicare is a health insurance program that provides coverage for people who are 65 and older or who qualify due to certain conditions or disabilities.
The Medicare insurance program has various parts and options for healthcare coverage.
Original Medicare combines Medicare Part A and Medicare Part B, with each part covering specific healthcare services.
Whether you are just getting started with Medicare or helping a loved one seeking coverage, you may be wondering what Original Medicare covers. Let’s take a look at that coverage below.
Medicare Part A (Hospital Insurance) Coverage
Medicare Part A provides coverage for inpatient care and services. This type of medical care is what you receive when you’ve been admitted to a hospital or Skilled Nursing Facility (SNF).
Generally, Medicare Part A provides coverage for:
● Skilled nursing services/nursing home care
● Lab tests
● Home health care
Medicare Part A is free for most beneficiaries, but you may be charged a monthly premium if you or your spouse didn’t work and pay Medicare payroll taxes for up to ten years. Medicare Part A also charges copays, deductibles, and coinsurance.
With Medicare Part A, costs and coverage are determined by a benefit period. A benefit period begins when a patient is admitted to a hospital or SNF. Once the patient has been out of the facility for 60 days, the benefit period stops. A new period begins after the previous 60-day period ends and if the patient is admitted into the hospital again. A deductible is charged by Medicare Part A for each benefit period and provides coverage for most costs up to a 60-day hospital stay.
Medicare Part B (Medical Insurance) Coverage
Medicare Part B provides coverage for most of the things you would get in a healthcare facility as an outpatient. It has an annual deductible of $203 (as of 2021) and a monthly premium of $148.50. Also, Medicare Part B pays 80 percent of Medicare-approved costs, leaving you responsible for the remaining 20 percent.
**Rates are subject to change. Please get in touch with us to get the latest rates.
The Medicare-approved treatment Part B covers include:
● Preventive care – immunization shots, cancer screenings, x-rays.
● Durable medical equipment – CPAP machines, insulin pumps, wheelchairs, etc.
● Counseling – opioid use, tobacco use prevention, alcohol misuse.
● Mental health services
● Ambulance services
● Some outpatient prescription drugs
If you need more information or help understanding Original Medicare coverage, contact our experienced Medicare Specialist at Medigap Supplement Headquarters today.
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