What is Original Medicare?
Original Medicare is individual insurance provided by the federal government. It has two parts:
Medicare Part A (hospital insurance) and Medicare Part B (medical insurance).
Medicare Part A
Helps pay for hospital stays and inpatient care
Medicare Part B
Helps pay for doctor visits and outpatient care
Who can enroll in Original Medicare?
You are eligible for Medicare benefits if:
- You are age 65 or older
- You have a qualifying disability at any age
- You have a diagnosis of end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS, also called Lou Gehrig’s disease) at any age
You must be a U.S. citizen or legal resident. Legal residents must live in the United States for at least 5 years in a row, including the 5 years just before applying for Medicare.
What is Medicare Part A?
Medicare Part A (hospital insurance) is one half of Original Medicare. It covers hospital stays and most of the services you receive as an inpatient in a hospital or skilled nursing facility. These include meals, lab tests and x-rays, operating room and recovery room services. Costs may not be covered by Part A if you are in the hospital for observation.
What is Medicare Part B?
Medicare Part B (medical insurance) is the other half of Original Medicare. It helps pay for outpatient services in a clinic or hospital, such as routine doctor visits, preventive items like flu shots or screenings, diagnostic tests such as X-rays, and emergency room services.
How do I enroll in Medicare Part A or Part B?
If you receive Social Security or Railroad Retirement Board benefits, you will be enrolled in Medicare automatically when you turn 65 and get your Medicare card in the mail. If you are not enrolled automatically, you will need to sign up by yourself. You can enroll online at www.ssa.gov, in person at your local Social Security office or by phone at 1-800-772-1213 (TTY 1-800-325-0778).
To learn more about enrolling in Original Medicare, watch this video .
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What is not covered by Original Medicare?
Original Medicare covers many hospital stays, inpatient care, doctor visits and outpatient care. It does not cover:
- Acupuncture
- Cosmetic surgery
- Custodial care that helps with daily activities, like eating and bathing
- Days spent in a psychiatric hospital beyond set limits
- Dental exams, cleanings, X-rays or routine dental care
- Eye exams, eyeglasses or contact lenses
- Hearing exams or hearing aids
- Long-term care (also called custodial care)
- Most care outside the United States
- Most prescription drugs
- Personal expenses while hospitalized, like a TV or phone service
- Routine foot care
- Wellness benefits such as gym memberships
Watch this video to learn more about the limits of what Original Medicare will cover.
What other Medicare plans are available?
Original Medicare is provided by the federal government. Other Medicare plans are offered by private insurance companies. Original Medicare does not cover most dental, vision or hearing care. It does not include coverage for most prescription drugs, or offer wellness benefits like fitness memberships.
Depending on your needs, a Medicare Advantage plan, Medicare Supplement Insurance (Medigap) plan or Medicare Part D prescription drug plan may be a good fit.
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