ORIGINAL MEDICARE

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Original Medicare is one of your health coverage choices as part of Medicare. You’ll have Original Medicare unless you choose a Medicare Advantage Plan or another type of Medicare health plan. You generally have to pay a portion of the cost for each service covered by Original Medicare.

• Medicare Part A and Part B cover certain medical services and supplies in hospitals, doctors’ offices, and other health care settings. 
• Prescription drug coverage is provided through Medicare Part D.

• Inpatient care in a hospital 
• Inpatient care in a skilled nursing facility (not custodial or long-term care) • 
• Hospice care  
• Home health care 
• Inpatient care in a religious nonmedical health care institution

• medically necessary doctors’ services 
• outpatient care
• home health services
• durable medical equipment
• mental health services, and other medical services. 
• Covers many preventive services.

Under Original Medicare, if the Part B deductible ($185 in 2019) applies, you must pay all costs (up to the Medicare-approved amount) until you meet the yearly Part B deductible. After your deductible is met, Medicare begins to pay its share and you typically pay 20% of the Medicare-approved amount of the service if the doctor or other health care provider accepts assignment. There’s no yearly limit for what you pay out-of-pocket.

• Medicare prescription drug coverage is an optional benefit. 
• Medicare drug coverage is offered to everyone with Medicare. 
• Even if you don’t use prescription drugs now, you should consider joining a Medicare drug plan. 
• If you decide not to join a Medicare drug plan when you’re first eligible, and you don’t have other creditable prescription drug coverage or get Extra Help, you’ll likely pay a late enrollment penalty if you join a plan later.

• Most dental care
• Eye exams related to prescribing glasses
• Dentures
• Cosmetic surgery
• Massage therapy
• Routine physical exams
• Acupuncture
• Hearing aids and exams for fitting them
• Long-term care
• Concierge care (also called concierge medicine, retainer-based medicine, boutique medicine, platinum practice, or direct care