Medicare is the federal health insurance program for people 65 and over; for disabled individuals receiving SSDI through Social Security; and those with Lou Gehrig’s (ALS) or End Stage Renal Disease (ESRD). Your (red, white and blue) Medicare ID card has your unique identification number and the effective dates of Part A or Part B, or both. Medicare has two additional parts: C and D. See below.
Parts A and B are called Original Medicare. When Medicare was signed into law in 1965, Parts A and B were the entire program.
Part A covers 1) inpatient hospitalization; 2) skilled nursing facility; 3) home health care; and 4) hospice.
Part B covers outpatient medical services: 1) physician visits; 2) laboratory and diagnostic tests; 3) ambulance; 4) urgent care and emergency treatment. And so on. Part B covers drugs that are administered in your doctor’s office or at a medical facility.
Can I use my Medicare I.D. card to get medical care?
Yes. You can see any doctor, or go to any medical facility, which accepts Medicare anywhere in the country.
Is Original Medicare Expensive?
It depends on how much you use it and what services you access.**
Part A is premium free if you’ve worked for ten years in the United States and paid into Social Security. But it’s not entirely free. Social Security will bill you $1,736 for a 60 day benefit period if you’re admitted as a hospital inpatient. This is your Part A deductible.
The monthly premium for Part B is $202.90. Medicare pays 80%. You pay 20%. For physician visits, 20% is typically reasonable. For more expensive services, such as MRIs, CT Scans, ambulance (ground and air) and ER visits, 20% can increase your debt burden.
Does Original Medicare pay for medications? No. You will need to enroll in a separate prescription plan (Medicare Part D).
How Can I Help Cover the Costs of Original Medicare?
There are two ways to help cover costs.
— You can enroll in a Medicare Advantage plan (Medicare Part C). Part C covers the benefits of Original Medicare but at a lower cost. It also includes extra benefits not covered by Original Medicare. Examples are routine dental, vision and hearing; health club memberships; and meals delivered to your home after an inpatient discharge. Private insurance companies offer Medicare Advantage plans. Many of these plans include drug coverage (Medicare Part D). For more information on Medicare Advantage on this website, select ‘Medicare’ on the Services tab at the top of the page.
— You can enroll in a Medicare Supplement plan. For more information, please see my blog on Medicare Supplement Insurance.
*This site is not affiliated with or endorsed by any government agency.
**For a complete list of Original Medicare costs, go to www.medicare.gov. Call 725-227-6795, email ken@deserthealthandlife.com or fill out a contact form on this website with any questions. I am a licensed insurance broker.
