What is Original Medicare (Part A and Part B)?

What is Original Medicare (Part A and Part B)?

The Medicare program began in 1965, after generations of citizens and politicians worked to establish a national health care system for America’s older population. This benefit is often referred to as "Original Medicare" or "Medicare Part A" and "Medicare Part B."

Original Medicare is a fee-for-service plan, which means you can go to any doctor, supplier, hospital, or other facility that is enrolled in and accepts Medicare, and is accepting new Medicare patients.

In 1972, Medicare became available to people with disabilities and End-Stage Renal Disease/kidney failure.

Confused by Medicare terms?

Look it up in the Cigna Medicare Glossary

Original Medicare
Part A
Hospital Insurance

You can enroll in Medicare Part A once you turn 65. If you’re already collecting Social Security disability benefits you'll be automatically enrolled in Part A.

Part B
Medical Insurance

Medicare pays 80% of approved charges and you pay about 20%.

Part B is optional because you have to pay a monthly premium and satisfy a deductible before Medicare will pay benefits.

Part A

Part A is the hospital insurance portion of Medicare. This benefit covers inpatient care, hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

You can enroll in Medicare Part A once you turn 65. If you're already collecting Social Security disability benefits you'll be automatically enrolled in Part A. Initial enrollment period packages are sent to individuals 3 months before they turn 65 or during their 25th month of disability benefits. You do not have to be retired to enroll in Medicare Part A.

If you do not automatically get premium-free Part A, you may be able to buy it if you (or your spouse):

  • Are age 65 or older and entitled to (or are enrolling in) Part B to meet the citizenship and residency requirements.
  • Are under age 65 and are disabled but no longer get premium-free Part A because you returned to work.

Part B

Part B provides many of the medically necessary services not covered in Part A. This includes coverage such as medical (doctor) services, outpatient care, and other medical items (diabetic test strips, nebulizers, and wheelchairs). You’ll also benefit from some covered preventive services.

Part B is optional because you have to pay a monthly premium and satisfy a deductible before Medicare will pay benefits. The monthly premium is based on your income.

Note: In some cases, your monthly premium may be higher if you did not sign up for Part B when you became eligible.

Part A and Part B do not cover everything. You’ll have to pay out-of-pocket for certain procedures unless you purchase supplemental insurance to cover the costs (Medigap). Even if Part A and Part B do cover a service or item, you generally have to pay deductibles, coinsurance, and copayments.

Need help paying for Medicare?

Medicare provides financial assistance for people who have limited income and resources. If you feel you may qualify, we encourage you to learn about the process and its eligibility requirements by visiting www.socialsecurity.gov on the web, or by calling the Social Security Administration at 1 (800) 772-1213. (TTY/TDD users should call 1 (800) 325-0778).

Where are you in your Medicare journey?

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