Original Medicare is health coverage for Seniors and disable people. The coverage  that is managed by the federal government and paid for by taxes. Most Medicare members are able to enroll into a Medicare plan once they turn 65 years old or if they have been disable for 24 months or more. Eligibility for Medicare can not be denied based on Health Conditions.

Medicare Part A : Hospital Coverage

MedicarePart A covers inpatient hospitalization. It also covers a range of inpatient services like skilled nursing facilities, hospice care, and some home health care. For most people who have worked the necessary 40 quarters or 10 years in the U.S.  there is not  a monthly cost for part A coverage.

Example of services covered under Part A :                      

  • Hospital room and meals
  • Care in special units, such as intensive care
  • Some blood transfusions
  • Drugs and medical supplies used during an inpatient stay
  • Hospice care, including medications to manage symptoms and pain
  • Lab tests, X-rays and medical equipment as an inpatient
  • Part-time, skilled care for the homebound after a qualified inpatient stay
  • Operating room and recovery room services
  • Rehabilitation services after a qualified inpatient stay

Medicare Part B: Medical Coverage

Medicare Part B covers most outpatient medical services. This includes doctors visits , specialist doctors visits, lab testing and other outpatient services. For most people who have Part B there is a monthly cost of $144. 60 but it may be higher if the member has a higher annual income.

Example of services covered by Medicare Part B

  • Doctor visits
  • An annual wellness visit and preventive services, like flu shots
  • Clinical laboratory services, like blood and urine tests
  • X-rays, MRIs, CT scans, EKGs and some other diagnostic tests
  • Some health programs, like smoking cessation and obesity counseling
  • Physical therapy, occupational therapy and speech-language pathology services
  • Diabetes screenings, education and certain supplies
  • Mental health care
  • Durable medical equipment for use at home, like wheelchairs and walkers
  • Ambulatory surgery center services
  • Ambulance and emergency room  services

Not Covered By Medicare Part A Or B

Medicare will generally cover 80% of a person’s outpatient costs. The remaining 20% cost is paid for by the Medicare Member. There is no limit to how much the members 20% can be, this  means that the yearly cost for a member can be very high.

Other common costs not covered by  Medicare Part A or Part B are prescription drugs that are purchased at the pharmacy, dental, or vision services.

Medicare Part B Penalty

If you didn’t get Part B when you were initially  eligible, you may be eligible for the  late enrollment penalty once you get part B coverage. The penalty will increase your  monthly premium by 10% for each 12-month period you could have had Part B, but didn’t. In most cases, you’ll have to pay this penalty each time you pay your premiums, for as long as you have Part B.

There are special exemptions from this penalty, especially if you had credible insurance coverage from outside of Medicare (i.e. work insurance, spouses work insurance, Veterans Benefits etc…).