Understanding Original Medicare

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 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.