Original Medicare Basics

Original Medicare is comprised of two parts:

• Part A -  helps pay for hospital stays
  and inpatient care.
• Part B - helps pay for doctor visits and outpatient care.

Medicare pays a fee for your care directly to the doctors and hospitals you visit.

Original Medicare has no limit to your out-of-pocket costs.

U.S. citizens and legal residents. (Legal residents must live in the U.S. for the 5 years just before applying for Medicare.)

You Must also meet one of the following:

• Age 65 or older
• Younger than 65 with a qualifying disability
• Any age with a diagnosis of end-stage renal disease or ALS

Part A costs (2022)

You usually don't pay a monthly premium for Part A if you or your spouse paid Medicare taxes for a certain amount of time while working. (Contact Social Security for more information about your Part A premium)

Part B costs (2022)

Most people will pay the standard premium of $170.10 per month for Part B. 

If your modified adjusted gross income is above a certain amount ($91,000 for Individual tax return or $182,000 for a joint return), you may pay an income related monthly adjustment amount for Part B.

Note - if your modified adjusted in gross income is above this amount you could also pay an adjusted amount for your Part D prescription drug coverage premium. 

Part A Hospital - covers inpatient hospital and skilled nursing care but you pay a $1,556 deductible per benefit period*

• After the deductible is met you pay $0 co-pay for days 1 - 60; on Days 61 - 90 you pay $389/day co-pay; on Days 91 and over you pay $778/day co-pay but Medicare limits how many days they cover.

Part B Medical - covers services like doctors and outpatient care when they are medically necessary.

You pay an annual deductible of $233.

After the deductible you pay 20% of all costs. 

• There are No max out-of-pocket limits and No prescription drug coverage.