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Getting Started: Understanding Original Medicare

by | August, 2017 | Medicare Basics

So, one day a red, white, and blue card shows up in the mail.  You’ve been waiting for it. You’ve paid decades of taxes to get it. Now, if you only understood how it worked.  Fortunately, it’s not as confusing as you may think…

Building Your Healthcare House

If you are a little bewildered about Medicare, take comfort.  You are not alone.  Medicare is like a house that has had many renovations.  It started out as a simple two-bedroom bungalow; and now, it is a sprawling rancher with a finished basement, a three-car garage, and a few secret passageways.

The red, white, and blue card you received entitles you to the protections and benefits of Original Medicare, the original two-bedroom bungalow consisting of Part A and Part B.  This is where everyone starts.

However, once you’ve moved in, it won’t take long before you’ll be bombarded with offers for Medicare Advantage plans, Medicare Supplement plans, and Medicare Prescription Drug plans.  Many people take advantage of these Medicare programs.  For example, of the roughly sixty million Medicare members, approximately twenty-five million will also add a Medicare prescription drug plan to their coverage; and another eighteen million will enroll in a Medicare Advantage plan.¹

Million Medicare Members

Medicare Drug Plan Members

Medicare Advantage Plan Members

These plans offer many perks and protections of their own, and you’ll be tempted to buy a new pool table for the basement and pick out new drapes for the in-law suite.  But, slow down.

Before you start navigating through this home’s additions, you may want to take a moment to learn a few basics about the original structure, known as Original or Traditional Medicare.  Understanding the coverages and costs under Original Medicare will allow you to accurately measure that coverage against your own healthcare circumstances.  This way, you can determine which types of additional coverage will best suit your needs and keep your Medicare dream home from turning into a money pit.

So, what is Original Medicare? To answer that question, let’s go back to the beginning…

The History of Original Medicare

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Hi!  I’m Tracey

I have been a licensed insurance agent for almost 10 years; and, I specialize in helping Florida residents discover insurance plans and programs that fit their unique needs. If you have questions, contact me today.

The purpose of the Medicare was to enable us, as a nation, to collectively care for the health of our neighbors who are older or who are coping with a disability.  It is a federal program that was originally proposed as merely an amendment to our nation’s existing Social Security benefit system. Like Social Security, we have lived with the institution of Medicare for so long that it is hard to believe there was any controversy associated with providing healthcare coverage to retired or disabled people, but there was.

It took eight years of debates, analysis, and compromises before H.R. 6675 was signed into law by President Lyndon B. Johnson on July 30, 1965. While it is a separate program overseen by the Centers for Medicare and Medicaid Services or CMS, the Social Security Administration still handles many of the member service functions for Medicare.  For example, if you need to request a new Medicare card, you must call the Social Security Administration, not the Centers for Medicare and Medicaid Services.

How Does it Work: Original Medicare

When Medicare was created, it had only two parts, simply titled Part A and Part B.  Part A generally provides coverage for in-patient care, and Part B is usually applied toward out-patient services. While Medicare was never designed to cover 100% of all medical expenses, these two parts, working together, manage to offer a tremendous amount of coverage for most medically necessary care.

It is important to understand exactly what each plan covers and what it doesn’t cover. You’ll also want to know what your cost responsibilities are under original Medicare.  To help you, we’ve broken it down into the two sections below. Once you’ve reviewed the coverage you have under Original Medicare, you’ll then want to think about you own healthcare needs and whether Original Medicare will be enough to meet those needs. Finally, you’ll want to talk with a licensed insurance agent to explore options for Medicare Advantage, Medicare Supplement, and Medicare Prescription Drug plans.  These plans can help fill the gaps left by Original Medicare.

If you’re ready to break ground on the construction of your healthcare house and learn more about the coverages and costs of Part A and Part B, click on each section below.

Why wait? Get your insurance questions answered today.

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