What is Original Medicare

Original Medicare includes two (2) main parts:

 

  1. Medicare Part A – Hospital coverage (coverage varies from service to service)
    It covers your inpatient hospital stays, your skilled nursing hospice, hospice, home-health (only if it's medically necessary).

    To get more information on Medicare Part A, please click here.
     

  2. Medicare Part B – Medical coverage (80 percent coverage, after deductible)
    This covers your doctor’s visits, your durable medical equipment, your lab tests, basic doctor visits, outpatient care, many preventative services.

    To get more information on Medicare Part B, please click here.

 

With Original Medicare, Medicare only covers 80 percent of your approved costs. Which means either you or a supplement plan will pay the remaining 20 percent.

 

Since the Federal Government administers original Medicare, it means that they are the ones negotiating the prices with your doctors and hospitals. They determine what they will get paid for the approved services they provide you.

 

That means, when you join Original Medicare, you can get care from any doctor or hospital across the entire country that who accepts Original Medicare.

Services Medicare DOES cover:

Therapy -  While Medicare has always covered physical, occupational, and speech therapy, in the past, they only covered up to a certain dollar amount. However, Medicare raised the cap on therapy, and now they will pay for much more treatment. This is important, especially for people with illnesses such as Parkinson’s, who need extensive treatment.

Chemotherapy Most people don’t know this, but Medicare Part B covers chemotherapy. Since health care professionals must administer chemotherapy, this care is covered under Medicare Part B, not your prescription plan.

Preventative Services - Some preventative services are part of the Affordable Care Act. You pay nothing for most of these services if you are in line with the rules.

Some of these services include:

  • Bone mass measurement

  • Various types of cancer screenings

  • Diabetes screening (you may be eligible for up to 2 diabetes screenings each year)

  • Cardiovascular disease screenings

  • Glaucoma tests

  • Flu Shots

  • Obesity screening and counseling

  • Wellness visits

Vision, Dental and Hearing - Medicare covers medically necessary vision, dental, and hearing services. However, it doesn’t cover non-medically necessary vision, dental, and hearing services. Not medically necessary services include annual exams, eyeglasses, dental fillings, and hearing aids.

 

Studies say that about 95 percent of U.S. doctors accept Original Medicare.

 

With that said, Original Medicare generally does not provide coverage for prescription drugs. There is an exception, though; it will cover medications that must be administered by a medical professional such as chemo.

 

For all other medications, you will need to get a separate, stand-alone, Medicare Part D drug plan.

 

Now, Medicare is complicated, and too many people make the wrong Medicare decision, which is jeopardizing their healthcare and their savings. This is why people turn to AJM Associates for help.