Original Medicare is health insurance, but results in a beneficiary having financial gaps in coverage: deductibles, coinsurance and no cap on out-of-pocket expenses. If a beneficiary has Original Medicare, there will be an effective date for Part A and another effective date of Part B on their Medicare Card (the dates can be the same or different, depending on the enrollment date for Part B).
1) Covers hospital and skilled nursing facility stays, some home health and hospice care
2) Premium: $0 for most people if you or your spouse/former spouse paid Medicare taxes for at least 40 calendar quarters (10 years)
3) Has a deductible in 2021 of $1,484… per benefit period. A new benefit period occurs once a beneficiary has been discharged from the hospital for 60+ days
1) Covers medically necessary services and some preventive services like doctor visits, lab tests, outpatient hospital care and durable medical equipment
2) Premium: $148.50 for most people in 2021, however those considered “higher wage earners” pay higher amounts. (See Blogs #1 and #5)
3) Has an annual deductible in 2021 of $203
4) Coinsurance: Medicare pays 80%, of covered benefit… you pay 20%
5) Medicare Part B can be deferred with no penalty if you have equivalent "creditable" coverage through an employer health plan (self/spouse)
To choose any additional Medicare plan, a beneficiary must have Medicare A and B and continue to pay their Part B premiums.
Most people enroll in a Medicare Supplement Plan or a Medicare Advantage Plan. These types of plans are mutually exclusive. This represents the basic health coverage decision, once you’re eligible for Medicare. Will you be better served on a Medicare Supplement Plan or a Medicare Advantage plan? That depends… we can help you make the decision that’s best for you, usually after a conversation and some analysis.