What Is Original Medicare‡ Part A And Part B
Is Original Medicare‡ Enough?
Original Medicare‡ is low-cost health insurance that comes from the government. It covers things like hospital stays and check-ups. Original Medicare‡ is made up of Parts A and B. Each covers different parts of your care.
Most people get Original Medicare‡ when they turn 65, but there are many things it doesn’t cover. We have plans to enhance your Original Medicare‡ coverage, help you pay for the things it doesn’t cover, and help save you money.
What Does Original Medicare‡ Cover?
Original Medicare‡ is made up of Parts A and B. Each covers different parts of your care.
| Medicare Part A | Medicare Part B |
|---|---|
|
Hospital Insurance |
Medical Insurance |
|
|
|
|
|
|
|
|
|
|
|
Original Medicare‡ Costs
Let’s look at how most people pay for Original Medicare‡.
| Part A | Part B |
|---|---|
|
You may have to pay a premium for Part A, but most people don't. If you or your spouse paid taxes into Medicare while you were working, you won’t have to pay premiums for Part A. If not, you can buy Medicare Part A and we can help cover some of its expenses. |
The cost of Part B varies depending on your income. Social Security uses your tax information to find out what you should pay. Most people pay either $104.90 or $121.80 a month for the Part B premium, and it can be deducted automatically from your Social Security check each month. |
Medicare Preventive Health
Original Medicare‡ includes many preventive health benefits. Take advantage of preventive care — it’s one of the best things you can do for your health. Regular check-ups, tests, shots and screenings can protect you from disease or injury, or lead to early detection and treatment that is more effective. Original Medicare‡ pays for many preventive health services, and some of our plans cover even more. Here’s a list of preventive services included with Medicare Part B.
Shots
- COVID
- Flu
- Hepatitis B (for people at medium to high risk)
- Pneumococcal
Exams
- One-Time “Welcome to Medicare” preventive visit (within the first 12 months of having Part B)
- Yearly “Wellness” visits
Other Preventive Benefits
- Cardiovascular disease (intensive behavioral therapy)
- Diabetes self-management training
- Medical nutrition therapy (for people with diabetes or renal disease)
- Obesity (intensive behavioral therapy)
- Smoking and tobacco use cessation counseling
Screenings
- Abdominal aortic aneurysm (for people at risk)
- Alcohol misuse (screening and counseling)
- Bone mass measurement
- Breast cancer (mammograms)
- Cardiovascular disease
- Cervical and vaginal cancer
- Colorectal cancer
- Depression
- Diabetes (for people at risk)
- Glaucoma (for people at high risk)\
- Hepatitis C (for certain ages and people at high risk)
- HIV (for people at increased risk)
- Pap test
- Prostate cancer
- Sexually transmitted infections (screening and counseling)
Does Original Medicare‡ Cover Ambulance Services?
Original Medicare‡ Part B covers ambulance transportation when you need to go to a hospital or skilled nursing facility for medically necessary treatment. Original Medicare‡ may also pay for emergency transportation in an airplane or helicopter if you need rapid transportation to a hospital that ground transportation can’t provide.
What Is Not Covered By Original Medicare‡?
Though Original Medicare‡ pays for many services, it doesn’t pay for everything. Medicare Advantage, Prescription Drug (Part D), Medicare Supplement Plans, and optional vision and dental plans are available for Medicare eligibles to help you with the things that aren’t covered.
Most prescription drugs are not covered by Original Medicare‡, but a Prescription Drug (Part D) Plan can help you save money on your prescription drugs. A Medicare Advantage Plan with Drug Coverage can too.
Original Medicare‡ will only pay 80 percent of the cost of doctor visits. With a Medicare Advantage plan, you will pay a small copay for doctor visits. For Medicare-covered services, Medicare Supplement plans can help cover some or all of the costs of doctor visits not covered by Original Medicare‡.
Original Medicare‡ will only pay a certain amount per day for hospital stays up to 150 days. With Medicare Advantage you will usually pay a lower copay per day for hospital stays. For Medicare-covered services, Medicare Supplement plans can help cover some or all of the costs not covered by Original Medicare‡ for hospital stays.
Medicare doesn’t cover regular vision exams, eyeglasses or contacts and it also doesn’t cover most dental care. But many of our Medicare Advantage Plans offer vision, dental and hearing coverage.
Original Medicare‡ vs. Medicare Advantage
Some of the benefits Medicare Advantage plans have that Original Medicare‡ doesn’t include:
Prescription drug coverage
Medicare Advantage plans can cover your prescription drugs, much like Medicare Part D. While Medicare Part D provides only prescription drug coverage, Medicare Advantage plans can cover that and more.
Dental care
Many Medicare Advantage plans offer dental coverage for things like routine check-ups and exams, cleanings, dentures, and coverage for unplanned dental procedures like root canals and crowns.
Vision care
Eye health and vision coverage becomes more important as we age. Eye exams, glasses, and contacts are a part of many Medicare Advantage plans.
Hearing care
Original Medicare‡ doesn't cover hearing aids, which can be expensive. Many Medicare Advantage plans provide hearing coverage that includes testing and medically required hearing aids.
Wellness and fitness
Medicare Advantage plans give you options for maintaining a healthy lifestyle. Many plans include access to gym memberships, senior fitness programs like SilverSneakers®, and coaching to improve overall well-being.
We offer Medicare Advantage, Prescription Drug (Part D), and Medicare Supplement plans in most areas of the country. Depending on the plan you choose, it may help you pay for some of what Medicare doesn’t cover for Medicare-approved services. Our Medicare Supplement plans also include value-added programs like SilverSneakers®.
And, in most states, one of our optional dental or vision packages can easily be purchased in addition to your Medicare Supplement or Medicare Advantage plan to complement your coverage. You receive allowances for the glasses or contacts you rely on and your check-ups and eye exams will be covered.
Need Help Paying For Original Medicare‡?
If you need help paying for the costs of Original Medicare‡, like deductibles or premiums, there are lots of programs to help. You can also apply for a Medicare Savings Program to help cover the costs of Original Medicare‡. To find out if you qualify for one of these programs, visit Medicare.gov or call your state’s Medicaid or local Social Security office. If you already have Medicaid or are enrolled in certain levels of the Medicare Savings Program, you may be eligible for a Dual Special Needs (DSNP) plan. These plans are designed for people who have Medicare and Medicaid and have no premium, medical copays or deductibles.
How To Sign Up For Medicare
We can help you understand the rules about when and how to sign up for Original Medicare‡ and the Medicare plans we offer such as Medicare Advantage, Prescription Drug (Part D), and Medicare Supplement on our Sign Up for Medicare page.
Find a Medicare plan that fits your needs. Explore your plan options.
Other Articles From "A Guide To Understanding Medicare Part D"
How to Enroll in Medicare Part D
Medicare Part D Costs
What is the Part D Coverage Gap?
Compare Part D Plans
What Is Original Medicare Part A And Part B?
What is Medicare Part D?
Why Choose Empire?
‡ Original Medicare: Part A (Hospital Insurance) and Part B (Medical Insurance).
Empire BlueCross BlueShield is a Medicare Advantage plan with a Medicare contract. Empire BlueCross BlueShield is a SNP plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Empire BlueCross BlueShield depends on contract renewal.