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Original Medicare – The Foundation of Traditional Fee-for-Service Healthcare Coverage

1 min read
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Original Medicare, also known as Traditional Medicare, is a government-sponsored healthcare program provided by the federal government in the United States. It is the fundamental form of healthcare coverage available to eligible individuals, primarily seniors aged 65 and older, as well as some younger individuals with qualifying disabilities. Understanding the key components of Original Medicare, its coverage options, and how it operates is essential for individuals seeking comprehensive healthcare benefits and services. In this article, we explore the features of Original Medicare and its significance as a foundational healthcare program.

Components of Original Medicare

Original Medicare consists of two primary parts that together provide healthcare coverage:

  • Medicare Part A: Part A covers inpatient hospital care, skilled nursing facility care, hospice care, and some home healthcare services. Eligible individuals do not usually pay a premium for Part A if they or their spouse have paid Medicare taxes while working.
  • Medicare Part B: Part B covers medically necessary services and supplies, including outpatient care, doctor visits, preventive services, durable medical equipment (DME), and certain vaccines. Part B requires a monthly premium, and the cost may vary based on income.

Cost-Sharing and Deductibles

Original Medicare involves cost-sharing, where beneficiaries are responsible for paying a portion of their healthcare expenses. This includes deductibles, copayments, and coinsurance. For example, beneficiaries must meet a deductible before Part A or Part B coverage kicks in, and they may also be required to pay coinsurance or copayments for specific services.

Supplemental Coverage and Medicare Advantage

To help with cost-sharing and to fill in the gaps of Original Medicare coverage, beneficiaries have the option to purchase private Medicare supplemental insurance, also known as Medigap. Medigap plans are standardized and offer additional benefits to cover some of the out-of-pocket expenses associated with Original Medicare.

Alternatively, some beneficiaries may opt for Medicare Advantage (Part C) plans, which are private health plans that provide all the benefits of Original Medicare (Parts A and B) and often include additional services like prescription drug coverage (Part D) and dental or vision benefits.

Original Medicare serves as the foundational healthcare coverage for eligible individuals in the United States, providing essential benefits such as hospital care and outpatient services. While it offers substantial coverage, beneficiaries should be aware of the cost-sharing aspects and consider supplemental insurance options like Medigap or Medicare Advantage to help with out-of-pocket expenses. By understanding the components of Original Medicare and exploring the available coverage options, individuals can make informed decisions about their healthcare needs and secure comprehensive and accessible healthcare services for a healthier and more secure future.

Tara Lemcke

Tara is an Content Writer at CoverRight focused on supporting the production of written and video content including researching, editing and publishing Medicare and health insurance-related information.

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