Getting Started: Understanding Original Medicare
Building Your Healthcare House
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
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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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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