Original Medicare (A & B)

Original Medicare (Part A and B)

Original Medicare consists of Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). Together, they form the core of Medicare coverage.

Here's a breakdown of each part:

Medicare Part A (Hospital Insurance)

Covers inpatient hospital stays, including critical access hospitals, inpatient rehabilitation facilities, and long-term care hospitals.
Also covers skilled nursing facility care (not long-term care or custodial care) and hospice care.
May also cover some home health services if certain conditions are met, such as being homebound and needing skilled care.

Costs for most people:

No monthly premium if you or your spouse paid Medicare taxes for at least 10 years.
Deductible of $1,676 per benefit period in 2025 (a benefit period begins when you're admitted and ends when you haven't received care for 60 consecutive days).
Coinsurance may apply after certain lengths of stay (e.g., $419/day for days 61-90 in 2025).

Medicare Part B (Medical Insurance)

Helps cover medically necessary services like doctors' services, outpatient care, durable medical equipment, and certain other medical services that Part A doesn't cover.
Covers many preventive services, like screenings, flu shots, and your yearly "Wellness" visit.
Part B is optional, but if you don't enroll when first eligible, you may face late enrollment penalties.

Costs for most people:

Most people pay a standard monthly premium ($185 in 2025).
An income-related monthly adjustment amount (IRMAA) may apply if your income exceeds certain thresholds.
Annual deductible of $257 in 2025.
Typically, you'll pay 20% of the Medicare approved amount for services after meeting the deductible.

Important Notes:

Original Medicare does not cover everything. For example, it doesn't generally cover long-term nursing home care, routine dental care, eye exams, or most prescription drugs you pick up at a pharmacy.
You can choose to get your Medicare benefits through Original Medicare or a Medicare Advantage plan (Part C) from a private company. Medicare Advantage plans offer an alternative way to receive your Medicare benefits, typically combining Part A, Part B, and often prescription drug coverage (Part D) into one plan.
You may also choose to purchase a Medicare Supplement Insurance (Medigap) policy to help cover some of the out-of-pocket costs associated with Original Medicare. However, you can't have both a Medicare Advantage plan and a Medigap policy at the same time.

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