Original Medicare includes Parts A (hospital coverage) and Part B (general medical coverage). It covers most but not all the cost of most medically necessary services and supplies in hospitals, doctors’ offices, and other health care facilities.
Eligibility for Parts A & B
- 65 years old and older
- Any age, receiving SSI disability for at least 24 months
- Any age, receiving SSI disability due to Amyotropic Lateral Sclerosis (ALS)
- U.S. Citizen or legal alien with permanent resident status (5 or more years)
Costs for Part A
- No monthly premium/payment for most who are 65 and older AND have worked for at least 10 years and paid medicare taxes.
- No monthly premium/payment for those eligible for Medicare due to disability, ESRD, or ALS.
- Can be purchased by those that do not qualify for premium free coverage
- Late penalty maybe added to premium for those who do not buy Part A when they are first eligible. *Exceptions apply if individual was still covered by creditable coverage (employer plan or spouse's plan).
- Deductibles, copays, and/or coinsurance apply for services rendered
Costs for Part B
- Monthly premium/payment applies ($174.70 in 2024, maybe higher for higher income levels).
- Late enrollment penalty maybe added to premium for those who do not buy Part B when they are first eligible. *Exceptions apply if individual was still covered by creditable coverage (employer plan or spouse's plan).
- Deductibles, copays, and/or coinsurance apply for services rendered.
What Original Medicare does NOT cover
- Recipients using Original Medicare alone are responsible for Part A and B decuctibles, copays, and coinsurance.
- Original medicare does not cover hearing, vision, dental, or prescription drugs.
Options to help cover the costs that Original Medicare does NOT cover
- Supplements Plans/Medigap policies can be purchased to help fill the "gaps" not covered by (deductibles, copays, and coinsurance).
- Prescription drug plans can be purchased and used along with original Medicare to help cover the costs of prescriptions drugs.
- Medicare Advantage Plans reduce out-of-pocket costs of Original Medicare and also obtain additional services such as hearing, vision, and dental. Select plans include prescription drug coverage and extra benefits like gym memberships and medical transportation.