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Medicare is the federal government program that provides health care coverage if you are 65+, under 65 and receiving Social Security Disability Insurance for a certain amount of time, or under 65 and with End-Stage Renal Disease.
Once you have become Medicare-eligible and enroll, you can choose to get your Medicare benefits from Original Medicare, or from a Medicare Advantage Plan, a type of private insurance offered by companies that contract with Medicare (the federal government).
What is the original Medicare?
Original Medicare consists of Part A and Part B. If you have Original Medicare, the government pays directly for the health care services you receive. Additionally, enrolling in Original Medicare means:
You will receive a red, white, and blue Medicare card to show to your providers
Most doctors in the country take your insurance
Medicare limits how much you can be charged if you visit participating and non-participating providers, but it does not limit how much you can be charged if you visit providers who opt out of Medicare
You can see a specialist without prior authorization
You are responsible for Original Medicare cost-sharing, which may include premiums, deductibles, and coinsurances
You are eligible to enroll in a Medigap policy, which can help reduce your out-of-pocket costs
In general, Part A covers:
Inpatient care in a hospital
Skilled nursing facility care
Nursing home care (inpatient care in a skilled nursing facility that’s not custodial or long-term care)
Home health care
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.
Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.
EPIA inc. is a private Insurance Agency with no ties with legal entities. The information contained in this article is based on information provided by the Medicare Official Website.