Original Medicare
Original Medicare combines coverage from Part A and Part B. Medicare Part A serves as hospital insurance and provides coverage for inpatient hospital care, skilled nursing facility care, home health care, and hospice care.
It is highly advised that even if you choose to delay your enrollment in Medicare Part B, that you still enroll in Part A as soon as you become eligible, in the month you turn 65.
Enrollment and Costs
For most Medicare beneficiaries, enrollment into Part A is done automatically. If you get benefits from Social Security at age 65, you will be automatically enrolled into Part B.
When you enroll, you will should receive your Medicare card and a booklet, which we highly recommended you read through. If you are still working, you will need to decide if you want to enroll in Part B at age 65. Prescription drug coverage is required (or you incur penalties), and if you want a Medicare Supplement (Medigap) or Advantage plan, you’ll need to enroll in those.
Most people receive Part A premium-free if they have worked for at least 10 years. If you are not eligible for Part A premium-free, you will have to sign up during the Initial Enrollment Period (within three months of your 65th birthday.)
As of 2023, if you are required to pay a premium for Part A, which ranges up to $506 per month. The deductible for each benefit period is $1,600.
Medicare Part B
Medicare Part B serves as medical insurance and covers outpatient expenses that are considered medically necessary to diagnose or treat a health condition. In 2023, the premium is $164.90 (or more, based on income) per month, which comes directly out of your Social Security benefit or is billed to you quarterly if you are still working.
There are several services covered under Part B, but you must receive your care or treatment from a Medicare-approved facility. It covers two main types of services, which include medically necessary and preventive services.
With Part B, you will receive coverage for:
- Durable medical equipment
- Mental health services (this includes inpatient, outpatient, and partial hospitalization)
- Ambulance services
- Clinical research
- And certain outpatient prescriptions, such as:
- Those with used with durable medical equipment
- Antigens
- Injectable osteoporosis drugs or other injectable drugs
- Blood clotting drugs
- Oral ESRD drugs
- And more
Eligibility and Enrollment
Your Initial Enrollment Period begins three months before your 65th birthday. Failing to enroll during this period could lead to permanent late enrollment penalties, which are added onto your monthly premiums
If you are required to pay the Part A premium, here are the requirements you must meet for Part B:
- You are 65 or older
- You are a U.S. resident
- You are a U.S. citizen
- You are a permanent legal resident who has live in the U.S. for at least five years
Cost
You will have out-of-pocket costs associated with Part B. As of 2023, the Part B premium is $164.90 but could be higher based on income. Part B also has a yearly deductible of $226.
There are penalties if you do not sign up for this and do not have creditable coverage. You will continue to pay the penalties for the rest of your life. Click here for more info from Medicare.gov.
Are You Nearing 65? Contact Us Today!
We are here to assist you through the Medicare enrollment process! If you have questions about Medicare, please call us at (918) 280-8025.