Original Medicare: Understanding Your Medical Insurance Options

Medicare is a federal government program that provides healthcare coverage for people 65 and older, as well as for certain younger individuals with disabilities. Original Medicare, also known as Medicare Part A and Part B, is the traditional Medicare program that is administered by the federal government. It is an important healthcare option for many Medicare eligibles, as it provides hospital insurance (Part A) and medical insurance (Part B) coverage.

In this article, we will explore the key features of Original Medicare, including its coverage, costs, and eligibility requirements. We will also compare Original Medicare to other Medicare options, such as Medicare Advantage and Medicare Supplement plans, to help you understand your medical insurance options and choose the right coverage for your needs.

Key Features of Original Medicare  

Hospital Insurance (Part A)  

Original Medicare Part A covers inpatient hospital care, including stays in acute care hospitals, skilled nursing facilities, and hospice care. It also covers certain home health services, such as nursing and therapy visits, and durable medical equipment.

Medical Insurance (Part B)  

Original Medicare Part B covers outpatient medical services, such as doctor’s visits, laboratory tests, and preventive care. It also covers certain medical supplies, such as wheelchairs and walkers, and some limited home health services.

Prescription Drug Coverage  

Original Medicare does not include prescription drug coverage. However, you can enroll in a separate Medicare Part D prescription drug plan to get coverage for your medications. These plans are offered by private insurance companies and are available to anyone with Original Medicare.

Out-of-Pocket Costs  

Original Medicare is free for most people 65 and over and those with certain disabilities. However, there are some costs associated with Original Medicare, including premiums, deductibles, copayments, and coinsurance.

Original Medicare requires you to pay deductibles, copayments, and coinsurance for the healthcare services you receive. The amount you pay out of pocket depends on the specific service you receive and whether you have met your deductible for the year.


Most people don’t pay a premium for Part A coverage because they or their spouse have paid Medicare taxes while working. However, you may need to pay a premium for Part B coverage depending on your income.

Eligibility for Original Medicare  

To be eligible for Original Medicare, you must be a U.S. citizen or permanent resident who is 65 or older, or you must be under 65 and have a disability or certain medical conditions. You are automatically enrolled in Original Medicare if you are already receiving Social Security benefits when you turn 65. If you are not receiving Social Security benefits, you must manually enroll in Original Medicare by contacting the Social Security Administration.

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Alternative Medicare Options 

In addition to Original Medicare, there are two other Medicare options that you may want to consider: Medicare Advantage plans and Medicare supplement insurance.

Medicare Advantage Plans  

Medicare Advantage plans, also known as Medicare Part C, are offered by private insurance companies and provide an alternative to Original Medicare. These plans typically offer a wider range of coverage, including prescription drug coverage, and often have lower out-of-pocket costs. However, they may have more restrictions on the healthcare providers you can see and the services you can receive.

Medicare Supplement Insurance  

Medicare supplement insurance, also known as Medigap, is a type of private insurance that is designed to supplement Original Medicare. These plans help cover the out-of-pocket costs of Original Medicare, such as deductibles, copayments, and coinsurance. There are several different types of Medicare supplement insurance plans available, each covering different costs and offering different levels of coverage.

Choosing the Right Medical Insurance Option  

When choosing your medical insurance option, it’s important to consider your healthcare needs, budget, and personal preferences. Original Medicare may be a good option if you are comfortable with traditional fee-for-service healthcare, want flexibility in choosing your healthcare providers, and don’t mind paying out-of-pocket costs.

Medicare Advantage plans may be a good option if you want comprehensive coverage, including prescription drug coverage, and are comfortable with the restrictions they may place on your healthcare options.

Finally, Medicare supplement insurance could be a good choice if you already have Original Medicare and want to protect yourself from high out-of-pocket costs.

No matter which option you choose, it’s important to do your research and make sure you understand the advantages and drawbacks of each option before making a decision.

It is also important to review your options on an annual basis as your needs may change over time. Additionally, Medicare Advantage plans and Medicare supplement insurance policies must be reviewed every year to ensure that they are still meeting your needs.

Finally, it’s important to be aware of any changes in the Medicare program that may affect your coverage. The federal government regularly updates and revises the Medicare program, so you should check with your health plan or Social Security Administration periodically to ensure you are getting the most up-to-date information.

By taking the time to explore your options and understand which option may be best for you, you can ensure that you are getting the medical coverage you need at a price you can afford.

If you have any questions or would like additional information on Medicare options, please contact us. We’re here to help you find the right coverage for your needs.

The information provided in this article is intended for informational purposes only and should not be construed as medical advice or professional counsel. Please consult with a broker from The Sosa Insurance Group before making any decisions regarding your health care coverage. The Federal government, Social Security Administration, and other entities mentioned herein are not responsible for the content of this article.

The Sosa Insurance Group makes no representations or warranties about the accuracy, completeness, or suitability of any of the information contained in this article and specifically disclaims any liability for any decisions you make based on the information provided herein. The Sosa Insurance Group does not provide medical advice and should not be relied upon for such advice.

Thank you for reading! We hope this article has been helpful in understanding the different Medicare options available to you. If you have any questions, please contact us at info@thesosainsurancegroup.com or 800-552-1934   and we’d be happy to help.  Good luck with finding the right plan for your needs!