What does ‘Original Medicare’ cover?

by Sandra Teel

Steel Medicare Insurance

What is “Original Medicare”? It’s NOT a Medicare Advantage nor a Medicare Supplement plan; Original Medicare is Parts A and B only.

Do you need a Medicare Advantage or a Medicare Supplemental plan when you have Original Medicare? Let’s explore why it would be important to get the extra coverage, and let’s start with Part A.

Part A is hospitalization insurance; it covers hospitals, skilled nursing facilities and hospice. There’s a $1,484.00 deductible for each period benefit. If you stay in the hospital for more than 60 days, you will have a daily charge of $371 per day for each benefit period in addition to your deductible. If you are in the hospital for more than 90 days, you will pay $742 per day until you hit your lifetime reserve, and then you will have to pay ALL related hospital costs. If you need a skilled nursing facility, you would be covered for a zero cost until the 21st day, and then you would have a co-pay until day 100.

There’s no maximum limit for out-of-pocket costs, which means you will continue to pay your portion until you leave the facility.

Part B is Medical Insurance, with a $203 deductible each year. After your deductible is met, you typically pay 20 percent of the Medicare-approved amount for most doctor services (including while you’re a hospital inpatient), outpatient therapy and durable medical equipment. Your hospital stay could become quite costly when you add in the doctor services at a 20 percent co-insurance rate.

Neither Part A nor B covers prescription drug costs. You would have to add an additional prescription drug coverage policy, which can be quite expensive.

This is why most people choose to combine a Medicare Advantage, which includes prescription drug coverage, or a Medicare Supplemental (Medigap) plan with drug coverage with their Original Medicare. This way, you would be covered for things not included with Original Medicare, as well as receive extra benefits such as vision, hearing, dental and more.

This can seem overwhelming, so it’s recommended you sit and talk with a professional about all your options.

Sandra Teel is a licensed independent broker. She can be contacted by calling (657) 2044224 or emailing steelmedagent@ gmail. com.