All about Medicare Part A & B, or Original Medicare
What is Medicare?
Medicare is the federal health insurance program primarily for Americans age 65 and older. Signed into law in 1965, Medicare currently covers over [60.8 million] people. Aimed primarily at those of retirement age, it helps make health coverage more affordable and less costly than private health insurance.
There are four different types of Medicare. Medicare Part A, also called hospital insurance, covers inpatient care; Medicare Part B, also called medical insurance, covers outpatient care. Together, they make up Original Medicare.
Medicare Part C, commonly referred to as Medicare Advantage, is an alternative to Original Medicare. Participants get many of the same benefits of traditional Medicare and more (like dental and vision, for example). Coverage is provided by private health insurers approved by the program. Medicare Part D is a prescription drug plan.
Medicare is not the same as Medicaid, a jointly funded state and federal health insurance program for vulnerable and low-income Americans in need of affordable care. Additionally, while Medicare is typically used by older people, anyone living with certain permanent disabilities may be eligible to get Medicare as well. While Medicare is often times premium-free — beneficiaries will pay deductibles and coinsurance for certain parts of this program.
What’s covered by Medicare?
Medicare Part A and Medicare Part B cover most standard medical services. Part A and Part B cover facility costs and Medicare-approved services you receive inside of those facilities. You may hear Part A called “hospital insurance,” and Part B called “medical insurance.”
Between Parts A and B, Original Medicare covers a wide range of services. For a deeper look into what you can expect from your Medicare policy, check out our information on Original Medicare Parts A and B coverage. myHealthPolicy can also help you with options like Medicare Advantage and Prescription Drug (Part D) coverage.
How much do Medicare part A and B cost?
For most people, their budget is front and center when considering which health insurance to choose. Here’s a starting point when working out your budget:
Medicare Part A costs for 2021
Premium: $0 (for most people)
Keep in mind:
- You’ll want to know if you’re responsible for paying a premium. Most individuals don’t have a Part A premium, but it can vary from person to person based on employment and tax history.
- You’ll be responsible for your Part A deductible.
Medicare Part B costs for 2021
Keep in mind:
- Medicare Part B has a standard yearly deductible cost.
- Medicare Part B has a standard monthly premium cost.
The standard premium for Medicare Part B is income-based. For both Part A and Part B, after you meet your deductible, your cost for care will be approximately 20%, and Medicare will pay about 80% for the remainder of your benefit calendar year.
There are plenty of other factors to consider, including copayments, co-insurance, and when to enroll. Learn more about what goes into Original Medicare costs.
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How do I get original Medicare?
If you’re 65 and getting Social Security or Railroad Retirement Board benefits, you will be automatically enrolled in Original Medicare (Parts A and B). You can expect your card in the mail three months prior to your 65th birthday.
If you’re 65 and not getting Social Security or Railroad Retirement Board benefits, you’ll need to enroll. You can start signing up when you are 64 years and 9 months old , the start of your seven-month initial enrollment period. It ends three months after your 65th birthday. For example, if your birthday is May 1, then your initial enrollment period is January 1 to July 31. After that, you may need to wait until the next Medicare Open Enrollment period. Medicare Open Enrollment starts October 15, 2021.
You can apply for Medicare three ways: 1) via online application, 2) by visiting your local Social Security office, or 3) calling Medicare at 1-800-772-1213.
You don’t need to reapply for Medicare each year. You can review and change coverage each Open Enrollment period. (Medicare Open Enrollment is separate from Open Enrollment for individual marketplace plans). If you made any changes to your Medicare coverage during this time, those changes take effect on January 1.
When am I eligible to enroll in Medicare?
The majority of Americans that choose Medicare health insurance plans are age 65 or older. If that’s you, you’ll want to remember the seven-month rule, which says that you have seven months to enroll in Medicare.
For example, if you turn 65 in August:
- Three months before your birth month: May, June, July
- Your birth month: August
Younger Americans with end stage renal disease (permanent or terminal kidney failure) or Lou Gehrig’s disease (amyotrophic lateral sclerosis, or ALS) are also eligible for the federal program.
|Type of Medicare||Coverage||Required||Cost|
|Medicare Part A||Yes||Usually no premium. Some procedures require deductible, copay, or coinsurance|
|Premium, low deductible, coinsurance|
|No||Varies by plan|
|Prescription drug plan||Varies by income and plan|
||No||Premium, deductible, copay
Is Medicare the right choice for you?
Here’s a recap of Original Medicare, its costs, how to enroll, and what it covers:
Original Medicare is one way to get Medicare. The other way is Medicare Advantage. We recommend you also take time to learn about Medicare Advantage, Medigap, and Out-of-pocket costs. These are all important pieces of making the best decision for your care. You can always contact a myHealthPolicy licensed insurance agent to get answers. Your myHealthPolicy works for you, not insurance companies, and will take time to discuss all your options.