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What is original Medicare? Medicare is broken up into 2 parts and is referred to as "original Medicare". Since Medicare's inception in 1965, it has gone threw many changes. Medicare was originally designed as a single payer insurance system to cover people turning 65 and is paid for by payroll taxes. Original Medicare was expanded in 1972 to cover people with disabilities after 24 month of being on Social Security Disability Income (SSDI). The program helps to pay for many medical care services, including hospitalizations, physician visits, prescription drugs, preventive services, skilled nursing facility and home health care, and hospice care. Learn more about Medicare's history
Most people are entitled to a no-premium Medicare Part A when they turn 65 as long as they worked at least 10 years and paid payroll taxes, if not they pay a Medicare Part A premium. A person can enroll in Part B when turning 65 or after they retire from employment. If a person is on Social Security Disability Income (SSDI) for 24 months they are automatically enrolled.
Original Medicare Part A is hospitalization and Part B is medical (outpatient services). There are out of pocket expenses associated with original Medicare after deductibles are paid Medicare then pays the Medicare approved amount and you pay your co-insurance. Original Medicare only covers medically necessary treatments and procedures.
Not everything is covered under original Medicare, there are deductibles, co-insurance and co-pays and there is no maximum out of pocket (MOOP). There are some limitations as to what Medicare will cover as well, for example original Medicare no longer covers personal blood pressure cuffs or maintenance supplies for c-pap machines. Original Medicare is evolving all the time with what they are now covering too. For example even 10 years ago original Medicare did not cover continuous glucose monitors (CGM) for people with TYPE 1 diabetes, today Medicare does. It also pays to know which part of Medicare covers what services. Getting to know what is and is not covered by Medicare can save you money and headaches.
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