Will Original Medicare Meet My Coverage Needs?
August 18, 2021 | Kari Mellone
Today, we’ll discuss Original Medicare in-depth. This will help you understand what it is, what type of coverage it includes, the cost of the plan, and if it fits your needs.
What is Original Medicare?
Original Medicare consists of Part A (hospital insurance) and Part B (medical Insurance). These include things like hospitalizations, skilled nursing, doctor visits, x-rays or other scans, bloodwork, and outpatient surgery.
What Is the Cost of Original Medicare?
In Original Medicare, you pay a premium for Part A and/or Part B and a deductible (set amount) before your Medicare coverage kicks in. Then, you will pay for your share of the expenses. Generally, Medicare pays for 80% of covered services, and you are responsible for 20% coinsurance. It’s important to note that Original Medicare does not have a cap on the amount you will pay.
Can I See My Doctor If I Have Original Medicare?
Generally, yes. You can see any health care provider or go to any facility that accepts Medicare and accepting new Medicare patients. You don’t need a referral to see a specialist, as long as the specialist accepts Medicare.
Are Prescriptions Covered?
Most prescription medications are not covered by Original Medicare, with a few exceptions. In most cases, you will need to sign up for a Medicare Part D plan to get prescription drug coverage.
Factors that Affect Medicare Out-of-Pocket Costs
There are a variety of factors that may affect your Medicare out-of-pocket costs, including:
- The type of health care you need, and how often you need it.
- Whether you have other health insurance that works with Medicare.
- Whether you have Medicaid or state assistance.
- Whether you have a Medigap (Medicare Supplement Insurance) policy.
Does Original Medicare Meet Your Coverage Needs?
This depends on your unique personal situation. Original Medicare may leave gaps in your health care coverage, which is why many people look at additional coverage options. The experienced agents at Twin City Underwriters can help you determine whether other Medicare plans, such as Medigap, Medicare Advantage, or Part D would be ideal options for your needs.
Do you have questions about what your Medicare plan covers? Contact Twin City Underwriters today.
Choosing a Medicare plan can be difficult. Working with an insurance broker can help you find a plan that fits your needs. Schedule a one-on-one meeting with one of our Minneapolis insurance brokers to get your insurance questions answered!