Introduction to Medicare

Medicare is the national health insurance program that is offered to individuals 65 and older and some people under 65 who have specific disabilities.

Created in 1965, Medicare started with just two parts – Part A and Part B, also referred to as Original Medicare. Later on, additional parts – Part C and Part D – were added as the needs of Medicare beneficiaries changed.

We break Medicare down so you can better understand it and know how to enroll and choose a plan that is right for you.

What Are the Different Parts of Medicare?

Original Medicare consists of Parts A and B. These are sponsored by the government.

It is important to understand that Original Medicare (Parts A and B) does not cover all of your medical expenses. Because of this, other Medicare plans exist to help provide additional coverage for those who need it.

Part C, or Medicare Advantage, plans are private health plans. This Medicare insurance plan includes coverage for everything Parts A and B cover, and sometimes Part D, depending on the plan.

Part D, or Prescription Drug Coverage, plans are also private health plans. They offer coverage for prescription drug costs.

Medicare Supplement (Medigap) plans help pay some costs not covered by Original Medicare Parts A and B. Plans are private health plans as well.

Senior woman doing the hula hoop
Medicare Basics Guide

Medicare Basics Guide

Florida Blue provides the information you need to choose the Medicare plan that meets your needs and budget.

Medicare and You Guide

Medicare & You

U.S. government handbook on Medicare benefits, rights, and protections, available health plans and more.

What Does Original Medicare (Parts A and B) Cover?

Part A

Medicare Part A covers inpatient care, which includes:

  • Hospital care
  • Skilled nursing facility care
  • Short-term nursing home care
  • Hospice care
  • Home healthcare services*
  • *In limited circumstances

Part B

Medicare Part B covers many outpatient services and supplies, which includes:

  • Doctor’s visits
  • Some preventive care
  • Laboratory tests
  • Mental health
  • Durable medical equipment (DME)
  • Ambulance services

What Does Original Medicare Not Cover?

Prescription drugs

Dental exams, most dental care or dentures

Routine eye exams, eyeglasses or contacts

Hearing aids or related exams or services

Most care while traveling outside the United States

Chiropractic, acupuncture or other alternative treatments

Deductibles and copays for Parts A and B

You may have to pay for these services yourself unless you have other insurance that covers them.

What Does Original Medicare Cost?

 

Original Medicare helps pay for many healthcare services and expenses but shares the cost of care through deductibles, copayments (copays) and coinsurance. Original Medicare Part A and Part B have their own separate costs associated with each part. Costs vary from person to person.

 

Your Original Medicare (Parts A and B) costs may include:

  • Deductible - The amount you pay before Original Medicare begins to pay its share of the cost.
  •   Copay - A flat dollar amount (for example, $10) you pay each time you receive care.
  • Coinsurance - A percentage (for example, 10%) you pay for your care after you meet your deductible.
  • Premium - A fixed, monthly amount you pay for your Original Medicare plan coverage. Most people will only have a premium for Part B.

Cost Differences Between Original Medicare Parts A and B

  Part A Part B

For most people, Part A has no monthly premium.

You pay a deductible and out-of-pocket expenses with Part A, unless you have a separate Medicare Supplement plan.

Part B usually has a monthly premium.

For most services, you pay a yearly deductible and coinsurance with Part B, unless you have a separate Medicare Supplement plan.

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Last Updated: 10.01.2021
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