Vincent Thrasher
Founder at - over65 insurance optionsVincent Thrasher, the pioneering founder of Over65InsuranceOptions, has an impressive 20-year tenure in the insurance industry. His in-depth expertise spans the entire spectrum of senior...Read more
Original Medicare is a healthcare program provided by the U.S. federal government that covers basic medical services for seniors and people with disabilities. If you’re enrolled in Original Medicare, you may be wondering what medical services and items are covered under this program. In this article, we’ll take a closer look at what Original Medicare covers and what you can expect from this healthcare program. Let’s dive in!
What Does Original Medicare Cover?
Original Medicare is a government-run health insurance program in the United States that provides basic coverage for medical expenses. The program is divided into two parts: Part A and Part B. Part A covers hospital services, while Part B covers doctor visits, outpatient care, and preventive services.
Part A Coverage
Part A covers inpatient hospital care, skilled nursing facility care, hospice care, and home health care. Inpatient hospital care includes room and board, nursing services, and meals. Skilled nursing facility care includes semi-private rooms, meals, skilled nursing care, and rehabilitation services. Hospice care includes medical and support services for people who are terminally ill. Home health care includes skilled nursing care, physical therapy, occupational therapy, speech-language pathology services, and medical social services.
In addition to these services, Part A also covers blood transfusions, durable medical equipment (DME), and some clinical research studies. However, there are limits on how much coverage you can receive for each service. For example, Part A covers up to 100 days of skilled nursing facility care per benefit period.
Part B Coverage
Part B covers doctor visits, outpatient care, preventive services, and medical equipment. Doctor visits include visits to primary care physicians, specialists, and other healthcare providers. Outpatient care includes procedures that do not require an overnight stay in a hospital, such as diagnostic tests, lab work, and X-rays. Preventive services include screenings for cancer, cardiovascular disease, and other health conditions.
Part B also covers medical equipment, such as wheelchairs, walkers, and oxygen equipment. However, there are limits on how much coverage you can receive for each service. For example, Part B covers up to 80% of the cost of most services, and you are responsible for paying the remaining 20%.
Benefits of Original Medicare
One of the benefits of Original Medicare is that it provides basic coverage for medical expenses. This can be especially helpful for people who have chronic health conditions or who need frequent medical care. Another benefit of Original Medicare is that it is widely accepted by healthcare providers, which means that you can usually see any doctor or specialist who accepts Medicare.
Drawbacks of Original Medicare
One of the drawbacks of Original Medicare is that it does not cover all medical expenses. For example, it does not cover prescription drugs, dental care, or vision care. Another drawback of Original Medicare is that it can be expensive, especially if you need a lot of medical care. You may need to pay deductibles, copayments, and coinsurance, which can add up quickly.
Original Medicare vs. Medicare Advantage
Medicare Advantage is an alternative to Original Medicare that is offered by private insurance companies. Medicare Advantage plans often provide additional benefits, such as prescription drug coverage, dental care, and vision care. However, they may also have more restrictions on which doctors and hospitals you can see.
If you choose to enroll in Medicare Advantage, you will still be enrolled in Medicare, but you will receive your benefits through a private insurance company. You may also need to pay additional premiums for your Medicare Advantage plan.
Conclusion
Original Medicare provides basic coverage for medical expenses, but it does not cover all medical expenses. If you need additional coverage, you may want to consider enrolling in a Medicare Advantage plan. However, before you make a decision, it’s important to carefully review your options and consider your healthcare needs and budget.
Frequently Asked Questions
What is Original Medicare?
Original Medicare is a federal health insurance program that provides healthcare coverage for Americans aged 65 and older, as well as for individuals with certain disabilities and those with end-stage renal disease. Original Medicare is made up of two parts: Part A and Part B.
Part A provides coverage for inpatient hospital care, skilled nursing facility care, hospice care, and home health care. Part B provides coverage for doctor visits, outpatient services, preventive care, and medical equipment.
What Does Original Medicare Cover?
Original Medicare covers a wide range of healthcare services, including hospital stays, doctor visits, and medical treatments. Part A covers inpatient hospital care, skilled nursing facility care, hospice care, and home health care. Part B covers doctor visits, outpatient services, preventive care, and medical equipment.
Original Medicare also covers certain prescription drugs, although coverage is limited. To get more comprehensive prescription drug coverage, you can enroll in a Medicare Part D plan.
What Services are Not Covered by Original Medicare?
Original Medicare does not cover all healthcare services. Some services that are not covered include long-term care, dental care, vision care, hearing aids, and cosmetic surgery. Additionally, Original Medicare may not cover all of the costs associated with covered services, such as deductibles, copayments, and coinsurance.
To help cover these costs, you can purchase a Medicare Supplement Insurance (Medigap) policy or enroll in a Medicare Advantage plan.
Can I See Any Doctor with Original Medicare?
With Original Medicare, you can see any doctor who accepts Medicare patients. However, some doctors may not accept new Medicare patients or may not accept Medicare assignment, which means they may charge more than the Medicare-approved amount for their services.
To avoid extra costs, it’s important to check with your doctor before making an appointment to ensure they accept Medicare assignment.
How Do I Enroll in Original Medicare?
To enroll in Original Medicare, you must be a U.S. citizen or a legal resident who has lived in the U.S. for at least five continuous years. You are eligible for Medicare when you turn 65 or if you have a qualifying disability.
If you are already receiving Social Security benefits, you will be automatically enrolled in Original Medicare. If you are not receiving Social Security benefits, you can enroll in Medicare by visiting the Social Security Administration website or by calling their toll-free number.
In conclusion, Original Medicare is a federal program that provides health insurance coverage to eligible individuals aged 65 or older, as well as some younger people with disabilities. It is made up of two parts: Part A (hospital insurance) and Part B (medical insurance).
Part A covers inpatient hospital care, skilled nursing facility care, hospice care, and some home health care. Part B covers medically necessary services and supplies, such as doctor visits, outpatient care, preventive services, and durable medical equipment.
However, it’s important to note that Original Medicare does not cover all healthcare services and supplies. For example, it does not cover prescription drugs, dental care, vision care, hearing aids, or long-term care. To get coverage for these services, you may need to enroll in additional insurance plans. It’s important to carefully review your healthcare needs and options to ensure you have adequate coverage.
Vincent Thrasher, the pioneering founder of Over65InsuranceOptions, has an impressive 20-year tenure in the insurance industry. His in-depth expertise spans the entire spectrum of senior insurance, encompassing Medicare, Medigap, long-term care insurance, life insurance, and dental, vision, and hearing insurance. Vincent's unwavering passion for guiding seniors through the intricate insurance landscape and crafting customized solutions to address their individual needs has earned Over65InsuranceOptions an esteemed reputation as a dependable ally for seniors nationwide.
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