Original Medicare (Medicare Part A and B)

Published: Wednesday, July 25 2018
Last Updated: 3 months ago

Are you turning 65 soon? If so, you may have received a red, white, and blue Medicare card in the mail. If you’re not sure what it is, don’t worry, you’re not alone. If you received your Medicare card, you have most likely been automatically enrolled in Original Medicare, and here’s what it means.

What Is Original Medicare?

Original Medicare consists of two different parts, Medicare Part A and B, which are both managed by the federal government. Original Medicare is also known as Traditional Medicare, as well as Fee-for-Service Medicare because the federal government pays medical providers for each service they provide to Medicare beneficiaries.

The Difference Between Medicare Part A And B

While both Medicare Part A and B are together referred to as Original Medicare, each part handles different aspects of your healthcare. Together, Medicare Parts A and B will cover the majority of your healthcare costs, but without both, your coverage won’t be nearly as comprehensive.

Benefits Covered By Original Medicare

Medicare Part A is what’s referred to as hospital insurance. Part A is responsible for inpatient hospital stays, the care you receive at skilled nursing facilities, hospice care, and even some of your healthcare.

Medicare Part B is a bit different and is referred to as medical insurance (similar to health insurance plans you purchase before Medicare). Part B is responsible for covering some of your trips to see the doctor, outpatient care, necessary medical supplies, and your all your important preventive services.

Benefits Not Covered By Original Medicare

Between Medicare Parts A and B, Original Medicare will provide coverage for the majority of your healthcare needs. However, there are still certain services that are not covered by Original Medicare, which are called gaps in coverage. Here are some of the medical services Medicare Parts A and B don’t cover:

  • Long-term care (also called custodial Care)
  • The majority of dental care
  • Eye exams for the purpose of prescription glasses
  • Dentures
  • Surgery or procedures that are considered cosmetic
  • Acupuncture
  • Hearing aids
  • Foot care that is considered routine

While Original Medicare may not include benefits to cover these services, there are additional Medicare parts and plans you can enroll in to make sure you are covered. Medicare Advantage, Medicare Part D, and Medicare Supplemental (Medigap) Plans all give you additional benefits.

How Original Medicare Works

Most American seniors will become eligible for Original Medicare once they turn 65 years old, though there are exceptions. Typically, 3 months before your 65th birthday you will receive your Medicare card (red, white, and blue card) in the mail, and you will automatically be enrolled in both Medicare Part A and B. Medicare Part A is usually free, whereas Medicare Part B does require a monthly premium that varies depending on income.

If you haven’t received your Medicare Card in the mail, you may need to sign up for Medicare Part A and B on your own. At this point, you will need to wait until your Initial Enrollment Period, which is the 7 months surrounding your birthday (3 months before, birthday month, and 3 months after). To sign up for Original Medicare you will need to:

  • Visit the Social Security Office nearest to you
  • Call the Social Security Office - (800) 772-1213
  • Mail in a letter or application
  • Apply online at www.ssa.gov

Once enrolled, you will have access to your Original Medicare benefits. One of the greatest things about Medicare, aside from its affordable cost, is the ability to go to just about any medical provider. Almost all doctors, medical suppliers, hospitals, and medical facilities accept Medicare patients, so you don’t need to worry about provider networks. You also don’t have to worry about getting a referral to see a specialist with Original Medicare.

Original Medicare does carry some of the same out-of-pocket expenses as traditional health insurance. You will, most likely, be required to pay a deductible before Medicare benefits kick in. After you deductible is paid, you still may have other costs such as coinsurance or copayments, unless you have an additional Medicare plan to help cover the costs.