After decades of relying on health insurance through your employer or private plan, making the transition to Medicare may feel like you’re entering into the great unknown. That’s because Medicare is set up much differently than the health plans you’re probably used to, and it can easily cause confusion.
To help you get started on your shift to Medicare, let’s begin with the basics: an overview of Original Medicare Parts A and B.
What is Original Medicare?
Original Medicare is the federal health insurance program primarily for Americans aged 65 and older. Covering millions of Americans, it helps make health coverage more affordable for retirees. Original Medicare is composed of two parts: Part A and Part B.
Are you eligible for Medicare? See if you meet one of these three requirements.
What is Medicare Part A?
Medicare Part A is oftentimes called “hospital insurance” because it helps cover hospital care for retirees. It can also help cover skilled nursing facility care, some nursing home care, hospice care and home health care. Part A has no provider networks and can be used at any health care provider that accepts Medicare.
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What is Medicare Part B??
Many people call Medicare Part B “medical insurance” because it helps cover services like doctor visits, outpatient care, medical supplies and preventive services. Part B also has no provider networks can be used at any health care provider that accepts Medicare.
What Are the Costs of Original Medicare Parts A and B?
Out-of-pocket Original Medicare costs may include premiums, deductibles, all costs for services and supplies that aren’t approved by Medicare, long-term care, and health care received outside the U.S.
- Part A costs: Most people don’t have to pay a monthly premium for Part A coverage if they paid Medicare payroll taxes during their working years. However, Part A beneficiaries do pay a deductible and possibly coinsurance.
- Part B costs: Unlike Medicare Part A, Part B does have a monthly premium. Beneficiaries also pay a yearly deductible and coinsurance.
Is Original Medicare Enough?
Original Medicare Parts A and B provide retirees good health insurance coverage, but many people hedge against out-of-pocket medical costs by choosing one of these options:
- They supplement their Original Medicare coverage with a Medicare Supplement insurance plan. These plans are sold by private companies and are designed to help you pay for out-of-pocket expenses that Medicare doesn’t cover through standardized benefits.
- They purchase a Medicare Part D prescription drug plan because prescription drugs aren’t covered by Medicare.
- Instead of Original Medicare, they sign up for a Medicare Advantage Part C plan that bundles their Part A and Part B benefits, plus possibly prescription drug, vision, hearing and dental coverage. One consideration of Part C is that these plans often have provider networks, which means you need to use certain doctors or hospitals to be covered.
When Can I Enroll in Original Medicare Parts A and B?
You have several opportunities to sign up for Original Medicare:
- During your initial enrollment period (IEP), which is a seven-month period that starts three months prior to your 65th birthday, includes your birth month, and ends three months after the month in which you turn 65.
- During the Medicare annual enrollment period (AEP), which runs from October 15 through December 7.
- During the general enrollment period (GEP), which happens January 1 through March 31.
Learn more about Medicare enrollment periods so you don’t miss out on signing up for coverage when you need it! so you don’t miss out on signing up for coverage when you need it!
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1U.S. Department of Health and Human Services, How Much Care Will You Need?, https://acl.gov/ltc/basic-needs/how-much-care-will-you-need, 2020.
2SeniorLiving.org, Nursing Home Costs in 2023, https://www.seniorliving.org/nursing-homes/costs/, 2023.
3Social Security Administration, What is the maximum Social Security retirement benefit payable?, https://faq.ssa.gov/en-us/Topic/article/KA-01897, 2023.
Colonial Penn is a private company that is not Medicare, Medicaid or MaineCare and is not a governmental agency
