Original Medicare Program

The Original Medicare Program consists of four parts, but at any given time, you will either be utilizing Part A, Part B, and Part D, or you will be enrolled in Part C. Let's break down the components of the Original Medicare Program:

MEDICARE PART A:


Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Most of the time Part A doesn't cost you anything in terms of monthly premiums as long as you have paid 40 quarters in the Medicare system through your taxes while you were working.

If you do end up needing to use your benefits, there is a large deductible that needs to be met before Part A starts paying benefits, but then you will be covered for the 1st 60 days after before you start to realize copays and coinsurance.


MEDICARE PART B:


Medicare Part B plans are outpatient medical coverage. Part B helps pay for medically necessary services performed on an outpatient basis that are needed to diagnose and treat a medical condition.

Visits to your Primary Care Physician, Specialists, Surgeries, lab work, and preventative services are all covered under Part B. The cost of Medicare Part B includes a monthly premium that you would be responsible for, withdrawn directly from your Social Security check if you are drawing Social Security. Otherwise, you would need to pay the premium three months at a time from your checking account.

There is a once-a-year deductible that you would have to meet before Part B pays anything, and then it is an 80/20 split where you would be responsible for 20% of the costs of service.


MEDICARE PART C:


Medicare Part C, also referred to as Medicare Advantage (MA or MAPD), is an alternative to Original Medicare. Medicare Part C coverage plans may include prescription drug coverage, along with other extra benefits., along with other extra benefits. It is offered through private insurance companies, so you don’t enroll in it at the Social Security office or website.

 These are usually network plans such as HMOs and PPOs with copayments and coinsurance found all throughout the plan based on services rendered. If you have an MA plan then this becomes your Primary Insurance and Original Medicare gets set aside but you will still need to continue paying your Part B premiums.

MEDICARE PART D:


Medicare Part D is your prescription drug coverage. Part D coverage is available as a Stand Alone Option (PDP) or as part of a Medicare Advantage plan (Part C). Part D plans, including Medicare Part D drug plans, are offered by private insurance companies contracted and approved by Medicare, and it is mandatory that you have credible drug coverage when you join Original Medicare or if you choose a Medicare Advantage plan. Understanding the Medicare Plan D cost is essential when considering your healthcare coverage options

To learn more about the options of having Original Medicare with a Supplement and Drug Plan OR choosing a Medicare Advantage plan, please click one of the buttons below. You can also always press the "Click to Call" button above to reach us today!

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