What is Original Medicare?

Smiling senior active couple sitting on the bench looking at tab

What is Original Medicare? The government-issued insurance covers over 63 million adults. It is one of the most extensive health insurance plans, but it can be confusing to navigate if you haven’t ever enrolled before.

Over the years, new plans have popped up, and out-of-pocket expenses have increased. If you are thinking about changing your Medicare coverage, we have you covered with a complete guide on what Original Medicare is and other plans available for you.

If you have an interest, keep reading for more information!

What Is Original Medicare?

When you ask, ‘what is Original Medicare plan?’ you might find many different results. In the simplest of terms, Original Medicare is health insurance offered to individuals over the age of 65.

There are some exceptions to this rule, but for the most part, you will need to reach the age of 65 before you qualify. Medicare mainly includes Part A and Part B benefits.

What is covered under Original Medicare? Part A includes all of your typical hospital stays, such as:

  • Inpatient care
  • Skilled nursing facilities
  • Home health
  • Hospice

There are restrictions on how long Medicare Part A will cover skilled nursing and inpatient care. Part B typically covers all of your outpatient visits and durable medical equipment (DME). It also includes coverage for:

  • Mental health treatment
  • Some prescription drugs

What is not covered by Original Medicare? These include long-term care, dental care, eye exams, and cosmetic surgery.

In most cases, prescription drug coverage falls under Part D. Medigap, or Medicare Advantage Plans are other options that can help cover additional costs. If you are already enrolled in Original Medicare, you qualify for Medigap.

Benefits of Medigap

What is the deductible for Original Medicare? In 2021, Part A coverage was almost $1,500 for the benefit period, and Part B was just over $200. This may not seem like a lot, but nearly 10% of Original Medicare policyholders paid approximately $10,000 in out-of-pocket costs.

One of the main benefits of Medigap is that it covers the high costs of deductibles and coinsurance.

Benefits of Medicare Advantage Plans

Two main criteria have changed over the years with Medicare – premiums increased, and Medicare Advantage plans offer greater benefits. These changes have primarily pushed many people to Medicare Advantage plans only offered through private groups.

There are not many pitfalls to Medicare Advantage plans. It offers the benefits of Original Medicare (including Part A and B) with supplemental coverage, such as:

  • Dental
  • Vision
  • Drug coverage

So – what is the difference between Original Medicare and Medicare Advantage? In the simplest of terms: more coverage. In many cases, you also don’t have any additional premium costs.

However, you will have to use the company’s in-network providers, or costs can drastically increase for out-of-network providers.

Medicare Plans for You

Googling, ‘what is Original Medicare?’ can lead to many confusing and overwhelming results. Enrolling in Medicare and choosing supplemental or Medicare Advantage plans is life-changing and can make a difference in your out-of-pocket costs.

Don’t go at it alone – we have a team of qualified agents that can help you through the enrollment process and choose the right plan for you and your loved ones. Contact us today for more information, or sign up for one of our free webinars!

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