What is Original Medicare (Part A and Part B)?
At HealthSpring, we believe understanding your Medicare coverage should be simple and empowering. Here’s a clear, friendly guide to Original Medicare—Parts A and B—to help you feel confident in your health care choices.
How Original Medicare works
Original Medicare includes two parts:
- Part A – Hospital Insurance: Helps cover hospital stays, care in skilled nursing facilities, hospice services, and some home health care.
- Part B – Medical Insurance: Covers outpatient services, doctor visits, clinical research, physical therapy and preventive care like flu shots and cancer screenings.
This fee-for-service program lets you see any provider who accepts Medicare and is welcoming new patients.
What’s covered by Parts A & B
Part A (Hospital Insurance) gives you access to:
Inpatient hospital care
Skilled nursing facility services
Hospice care
Home health care when needed
You’re eligible to sign up for Medicare Part A as soon as you turn 65. If you already receive Social Security disability benefits, you’ll be enrolled in Part A automatically—no action needed on your part.
Part B (Medical Insurance) covers:
Medically necessary treatments—from ambulance rides to outpatient therapies
Preventative services like screenings and shots
Medicare typically pays 80% of approved charges; you are responsible for the remaining 20%
Keep in mind that Part B is optional and includes a monthly premium and deductible.
What’s not covered?
Original Medicare doesn’t include:
- Long-term care (like nursing homes)
- Most dental services (e.g., dentures)
- Routine hearing examinations or hearing aids
- Eye exams for glasses
- Cosmetic treatments
- Routine foot care
- International health coverage
Who can enroll?
You may be eligible for Medicare Part A and Part B if you:
- Are 65 or older
- Have certain disabilities
- Have End-Stage Renal Disease (kidney failure)
- Have ALS (Lou Gehrig’s disease)
If you qualify based on age, enrolling early helps avoid gaps in coverage or penalties.
What about prescription drugs?
Original Medicare only covers medications given in hospitals or during outpatient treatments like injections. For regular prescriptions, you’ll need a Part D Prescription Drug Plan.
Costs at a glance
Both Part A and Part B include deductibles, copayments and coinsurance. Depending on your income and coverage history, some people may pay lower premiums for Part A—or none at all.
To help with out-of-pocket costs, you can explore Medigap (Medicare Supplement) policies, which work alongside Original Medicare to cover coinsurance, deductibles and more.
Need help paying for Medicare?
If your income or resources are limited, you may qualify for financial assistance with your Medicare costs. These programs can help reduce premiums, deductibles, and other expenses—so you can focus on your health, not your bill.
To learn more about eligibility:
Visiting www.socialsecurity.gov
Or call the Social Security Administration at
1-800-772-1213 (TTY users:1-800-325-0778 ).