Original Medicare – Parts A & B

Medicare is a US government health insurance plan for those 65 years or older or for people who have been disabled for at least 24 months. It is administered by CMS (Centers for Medicare and Medicaid).

Medicare Part A helps pay for inpatient hospital care, skilled nursing care and hospice.  It has a benefit period deductible of $1408.  Most people who have worked or had/have a spouse who contributed to Social Security, will pay NO premium for this portion.

Medicare Part B covers most everything else that is medically necessary (except prescription drugs).  This includes doctor office visits, lab work, X-rays, Emergency Room, durable medical equipment, and outpatient surgery.  The premium for this is on a sliding scale.  However, the standard premium is $144.60 /mo.  It has a once per calendar year deductible of $198.  Once the deductible has been met, Medicare Part B covers 80 percent of the costs.  

By today’s standards, Original Medicare is good insurance.  It has one major flaw.  It does not have a MOOP (maximum out of pocket) protection.  If a Medicare beneficiary becomes catastrophically ill, the deductibles and 20 percent co-pays can be financially significant.  Most people avoid this by purchasing either a Medicare Supplement or a Medicare Advantage Plan. 

The US Government wants you to have health insurance.  If you delay getting health insurance there is a late enrollment penalty.  However, if you turn age 65 and you or your spouse is/are still actively working and are covered by employer health, you can delay getting Medicare and not be subject to the penalty. 

You can apply for Medicare online at www.SSA.gov or in person at a local Social Security office. Additional information can be found at www.Medicare.gov.

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