Medicare Parts A and B – “Original Medicare”

Medicare Parts A and B make up “original Medicare”. If you are new to Medicare or unfamiliar with what it covers or how it works, this article is intended to give you the “10,000 foot overview” of Medicare Parts A & B, while being detailed enough to tell you what you need to know about Medicare and how it works.

So first and foremost, what is the difference between Medicare Part A and Medicare Part B? Medicare Part A is the part of Medicare that covers inpatient/hospital charges. You are entitled to Part A – with no required premium – if you have worked a minimum of 40 quarters during your working life.

Medicare Part B is the part of Medicare that covers outpatient/doctor’s visits. Part B is optional and also has a premium of $121.80/month in 2016. If you had Medicare Part B in 2015, it is likely that you are ‘grandfathered’ in under the ‘hold harmless’ provision at the 2015 Part B premium rate of $104.90/month.

The $121.80/month is the standard premium that most new-to-Medicare people pay, but it can be higher or lower based on income/assets. Some people may choose to defer Part B if they are still working and/or still covered by a group/employer plan.

Here is a partial list of medical services that fall under Part A:medicare card square

  • Hospital stays
  • Skilled nursing facility
  • Home health care
  • Hospice Care

Under Part B:

  • Doctor’s services
  • Labwork
  • Preventive care
  • Durable Medical Equipment
  • X-rays
  • Mental health care

Both parts of Medicare – Medicare Parts A and B – have a deductible that must be met before coverage begins. For 2016, these deductibles are $1288 for Part A and $166 for Part B. After the deductible is met, Medicare – generally-speaking – pays 80% and the beneficiary is responsible for the other 20%. Or, if you have a Medicare Supplement plan, those plans generally “supplement” A & B by paying some combination of the deductibles and the 20%.

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