Understanding Original Medicare

Learn how Medicare Part A and Part B work and what each covers

Original Medicare

Medicare is a government health insurance program for Americans who are 65 or older and younger people who have certain disabilities and receive Social Security benefits.

Medicare was first created in two parts, Part A and Part B. Together, they’re called Original Medicare.

Enrolling in Original Medicare

Learn about Medicare eligibility requirements and how to enroll in Original Medicare.

Learn more about Medicare enrollment

 
Medicare Part A: Hospital coverage

How Medicare Part A works

What Medicare Part A helps cover

What you pay for Part A

Medicare Part A helps pay for care you receive as an inpatient at a hospital or skilled nursing facility (SNF).

  • Inpatient hospital stays
  • Care in a skilled nursing facility
  • Unlimited home healthcare visits ordered by a doctor
  • Hospice care, including drugs to relieve pain

You will not pay a premium for Part A coverage if you or your spouse paid into Social Security for at least 10 years.

You must pay a deductible for each hospital or SNF benefit period. A benefit period begins when you are admitted to the hospital or SNF and ends when you have been out of the facility for 60 days in a row.

After you have paid the full deductible, Original Medicare will begin to pay all or some of the costs.

 
Medicare Part B: Medical coverage

How Medicare Part B works

What Medicare Part B helps cover

What you pay for Part B

Medicare Part B helps pay for medically necessary services and supplies needed for the diagnosis or treatment of your health condition.

You can choose not to enroll in Part B, but if you decide to sign up later, you may have to pay a late enrollment penalty for as long as you have Part B coverage.

  • Cancer screenings, such as mammograms
  • Doctor services in an office, clinic or hospital
  • Diagnostic tests, X-rays and lab tests
  • Medical supplies and equipment
  • Outpatient care and rehabilitation services
  • Ground ambulance transportation
  • Emergency department services

You must pay a monthly premium for Part B coverage. If you have qualifying health coverage, such as through an employer, the premium is separate from any monthly premium, copay or coinsurance you may pay for a private Medicare plan.

The monthly premium starts at a set price and increases on a sliding scale based on income. A single person with an annual income over a certain amount and married couples with an annual income over a certain amount will pay more.

The premium is usually taken out of your Social Security check. After you meet your yearly deductible, Part B generally covers 80% of the cost of most services you receive and you are responsible for paying the remaining 20% coinsurance.

Learn more about the cost of Original Medicare

Medical costs you could pay with Original Medicare alone

  • Annual physical exam
  • Routine vision care
  • Hearing aids
  • Most prescription drugs
  • Routine dental care
  • Long-term care

Medical costs you cannot pay with Original Medicare alone

  • Worldwide emergency
  • Urgent care
  • Transportation
  • Eligible health-related over-the-counter products
  • Fitness program

Medicare doesn't have to be hard

Blue Cross Advisor Katie Giziewski

Our Blue Cross Advisors are here to:

  • Help you learn about Medicare basics and our plans
  • Assist you in finding a plan that meets your needs
  • Help you enroll in a plan

Meet with a Blue Cross Advisor for free

Get your free Medicare Step-by-Step Guide

Blue Cross Medicare step-by-step guide

Learn the essentials of Medicare

Use this guide to make understanding Medicare easier. It covers the essentials you'll need to know, like the four parts of Medicare, when to enroll and how to avoid penalties.

Download Step-by-Step Guide - English [COMING SOON]

Download Step-by-Step Guide - Spanish [COMING SOON]

Register for a Medicare Workshop

Learn about Original Medicare and available plans based on the county you live in
at a free, no obligation, in-person or virtual workshop.

Find a workshop