What Do I Get With Original Medicare?
November 15, 2022 | Kari Mellone
You spend the first 65 years of your life contributing to Medicare taxes, so naturally, you may wonder: what do you get with Medicare? Are there any options for coverage beyond Original Medicare? This article will dig a little deeper into what you get with Original Medicare and the options available to you for additional coverage.
What is Original Medicare?
Original Medicare refers to Medicare Parts A and B. It covers many of your health needs, but it can leave significant gaps in your health coverage.
Medicare Part A
Medicare Part A covers care such as inpatient hospital stays, skilled nursing, and hospice. For most people, this Part A benefit will be at no cost if the beneficiary or their spouse has worked ten or more years in their life. If you qualify, you will not pay a premium for part A.
Part A has a deductible of $1556 in 2022. This is a per benefit period deductible, which means there is a possibility the beneficiary would pay this more than once. After that deductible, the member will pay a $0 copay for days 1-60, a $389 copay for days 61-90, and then $778 for the 60 “lifetime reserve days” each person is granted. There is also skilled nursing coverage for up to 100 days.
Medicare Part B
The second part of Original Medicare is Part B, which will cover your outpatient needs. Part B covers doctor visits, outpatient hospital services, certain preventive screenings, and durable medical equipment.
The monthly premium for part B is $170.10 for 2022 (or higher, depending on your income). There is a $233 (in 2022) annual deductible attached to part B. After that, it will be a cost share between Medicare and the beneficiary. Medicare will pay 80% of approved services, while the member pays 20%.
Beyond Original Medicare
Additional coverage options are available in the form of Medicare Advantage Plans (MA/MAPD). These plans are also known as Medicare Part C. In addition, you may want to purchase a Medicare supplement plan (also known as Medigap) and/or a Part D prescription drug plan. These plans can help cover gaps left by Original Medicare, such as a maximum out-of-pocket or coverage for an annual physical, which is not included in Medicare Parts A and B.
Each of these plans have their own unique characteristics. Determining which is right for you can be confusing and complex. Working with an experienced insurance broker can help you know your plan options and determine what is ideal for your individual needs.
Do you have questions about Medicare, and which plan is right for you? Twin City Underwriters offers free informational Medicare webinars and one-on-one consultations with Medicare insurance brokers where you can ask questions and get personal answers. If you need Medicare help, we can help you select the right coverage for your needs. To attend a Medicare workshop or set up an appointment, call us toll-free at 1-800-507-6778 or send us a message.