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What is Original Medicare?

Medicare is the federal health insurance program for:

  • People who are 65 or older

  • Certain younger people with disabilities

  • People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)

  • Original Medicare includes only Part A and Part B*

Medicare Part A
(Hospital)

In General, Part A covers: Inpatient Care in a hospital, Skilled Nursing Facility Care, Inpatient Care in a skilled nursing facility (not custodial or long-term care), Hospice Care and Home health care.

If you worked more than 10 years in the USA Medicare Part A has no monthly premium, if you worked less than 10 years you will pay a monthly premium which is dependent on how long you worked.

What you will pay for a hospital stay:

Days 1-60: $1,600 deductible, then nothing

Days 61-90: $400 per day

Days 91-150: $800 a day

After 150 days: You pay full cost of hospital stay

What you will pay for a stay in a Skilled Nursing Facility:

Days 1-20: $0

Days 21-100: $200 per day

After 100 days: You pay all costs

Home Healthcare Services and Hospice Care:

There is no deductible however you must meet a set of very specific criteria in order for Medicare to cover your care.

Medicare Part B
(Doctor)

Part B covers 2 types of services, Medically Necessary Services (services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice) and Preventive Services (health care to prevent illness, like the flu, or to detect it at an early stage when treatment is most likely to work best).

 

Depending on your income Medicare Part B will start at $164.90 per month. For persons with a higher income than $97,000 (single)/ $194,000 (couple) the part B premium cost for 2023 will be higher.

 

The Medicare Part B deductible is $226, Medicare will pay for 80% of approved Medicare costs and you will be responsible for the 20% left over. You will also be responsible for any amount, up to 15% that is not covered by Medicare. These charges are known as Part B excess charges.

Part D Prescription Drug Coverage is not covered under Original Medicare
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