What Is ‘Original Medicare’ and Is It Right for Me?

what-is-original-medicare-and-is-it-right-for-me

Medicare was created in 1965, as part of Lyndon B. Johnson’s “Great Society.” The program began offering government-funded hospital and outpatient medical coverage for seniors at a time when older, vulnerable people were mostly left to take care of themselves. That coverage is still offered today under the moniker “Original Medicare.”

Original Medicare is also sometimes called “Traditional Medicare,” but also described as Medicare Part A and Part B.

Simply put, Medicare Part A is hospital insurance. It provides broad coverage of hospital inpatient expenses, including not only hospital visits, but inpatient care in nursing facilities, home health services and hospice care. Part A coverage is typically free if you’re 65 or older, as long as you are a U.S. citizen or legal resident living in the country for at least five straight years before applying, and you or your spouse paid Medicare taxes during your working years.

Seniors are automatically enrolled in Medicare Part A, at no cost, if they’re scheduled to receive Social Security retirement benefits at 65. If not, a seven-month initial enrollment window applies beginning three months prior to an individual’s 65th birthday month. If you still aren’t enrolled, or you want to make changes to your coverage, there’s an annual Medicare Open Enrollment period beginning October 15 and ending December 7. This is also the time for existing participants to make changes.

Medicare Part B is the other half of Original Medicare. It’s commonly referred to as “medical insurance” because is covers medically necessary services, including doctors and nursing fees, X-rays, diagnostic tests, blood transfusions, chemotherapy, renal dialysis, certain vaccinations and preventive services. For 2018, most enrollees paid between $130-$134 per month.

Those slated for automatic Part A enrollment, will receive an early notification that they are Part B eligible. For those not scheduled for automatic enrollment, the initial seven month enrollment period applies to Part B just as it does for Part A. Medicare annual Open Enrollment Period, beginning Oct. 15, also applies.

Medicare offers an alternative to Original Medicare, which is known as Part C or Medicare Advantage.

Medicare Advantage plans combine Parts A and B coverage into one private health insurance plan, while offering additional coverage options. The same Part A and B enrollment timelines apply, although only about a third of Medicare beneficiaries opt for Medicare Advantage.

Do you have questions about Medicare or any of the health care planning options you may need as a Florida senior? Do not wait to ask us. We are here to help you with your planning needs.