Medicare is a health insurance program that provides coverage for people who are 65 and older or who qualify due to certain conditions or disabilities. The Medicare insurance program has various parts and options for healthcare coverage. Original Medicare combines Medicare Part A and Medicare Part B, with each part covering specific healthcare services. 

Whether you are just getting started with Medicare or helping a loved one seeking coverage, you may be wondering what Original Medicare covers. Let’s take a look at that coverage below.

Medicare Part A (Hospital Insurance) Coverage

Medicare Part A provides coverage for inpatient care and services. This is the care you receive when you’re admitted to a hospital or Skilled Nursing Facility (SNF). Generally, Medicare Part A provides coverage for:

  • Hospice
  • Skilled nursing services/nursing home care
  • Lab tests
  • Home health care
  • Surgery

Medicare Part A is free for most beneficiaries, but you may be charged a monthly premium if you or your spouse didn’t work and pay Medicare payroll taxes for up to ten years. Medicare Part A also charges copays, deductibles, and coinsurance.

With Medicare Part A, costs and coverage are determined by a benefit period. A benefit period begins when a patient is admitted to a hospital or SNF, but then stops when the patient has been out of the facility for 60 days. After these 60 days end and if the patient is admitted into the hospital again, a new benefit period will begin. A deductible is charged by Medicare Part A for each benefit period and provides coverage for most of the costs up to a 60-day hospital stay.

Medicare Part B (Medical Insurance) Coverage

Medicare Part B provides coverage for most of the things you would get in a healthcare facility when you are an outpatient. It has an annual deductible of $203 (as of 2021) and a monthly premium of $148.50. Also, Medicare Part B pays 80 percent of Medicare-approved costs, leaving you responsible for the remaining 20 percent. 

The Medicare-approved treatment Part B covers include:

  • Preventive care – immunization shots, cancer screenings, x-rays.
  • Durable medical equipment – CPAP machines, insulin pumps, wheelchairs, etc.
  • Counseling – opioid use, tobacco use prevention, alcohol misuse.
  • Mental health services
  • Ambulance services
  • Some outpatient prescription drugs

Need Help?

If you need more information about Original Medicare coverage, contact Medigap Supplement Headquarters today. Our experienced Medicare experts can help you understand Original Medicare and help you get the coverage you need.