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.
Parts A and B are called Original Medicare. Part A covers 1) inpatient hospitalization; 2) skilled nursing facility; 3) home health care; and 4) hospice. Part B covers outpatient medical services: Examples are physician visits, laboratory and diagnostic tests, ambulance, urgent care and emergency treatment. 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? 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 frequency of use and what medical services you access.* For example, Part A is premium free if you’ve worked for ten years in the United States and paid into Social Security, but Part A has a deductible. The deductible for 2026 is $1,736.00 for a 60 day benefit period. The monthly premium for Part B is $202.90. Medicare pays 80%. You pay 20%. If you see a primary care doctor or a specialist, 20% is typically affordable. If you need radiological tests, make use of ambulance services, or go to the emergency room, you could owe hundreds if not thousands of dollars.
Does Original Medicare pay for medications? You will need to enroll in a separate prescription plan (Medicare Part D). Stand alone prescription plans usually have a monthly premium. Only the most expensive drug plans omit a deductible for medications. For plans with zero or moderate premiums, expect to pay a deductible for all or certain medications.
How can I help cover the costs of Original Medicare? You can enroll in a Medicare Advantage plan (Medicare Part C). Part C covers the benefits of Original Medicare but at a lower cost. You may be able get a Medicare Advantage plan where an inpatient hospital admission is very low and where an emergency room visit won’t send you into debt. Medicare Advantage plans offer extra benefits not covered by Original Medicare. Some examples are routine dental, vision and hearing coverage and gym memberships. Many Medicare Advantage plans include drug coverage (Medicare Part D) with no premium. You can also enroll in a Medicare Supplement plan. Supplement plans are not the same as Medicare Advantage plans. 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. I am a licensed insurance broker.
