Original Medicare is made up of two parts, Medicare Part A and Medicare Part B. Medicare provides individuals with coverage access to hospitals, doctors or health care providers that accept Medicare. Medicare is a Federal Government program. People with Medicare typically pay a fee for services. Medicare pays an approved amount for services and the Medicare recipient pays the rest.
The U.S. Department of Health and Human Services is a federal agency that has a sub agency called the Centers for Medicare & Medicaid Services (CMS) which runs Medicare. U. S. payroll taxes paid by employers and workers finance a portion for Medicare. Premiums paid by Medicare beneficiaries deducted from Social Security also finance Medicare.
How Does Medicare Part A and Part B work?
- Does Original Medicare Cover prescription drugs?
- Situations are limited such as inpatient hospital visits. You may add prescription drug coverage by obtaining Medicare Part D.
- Can I see any Doctor or visit any hospital under Original Medicare?
- Yes, you may visit any facility, supplier, hospital or doctor that is enrolled and accepting Medicare patients.
- If I want to see a specialist, do I need a referral?
- No
- Do I need Medicare Supplemental Insurance?
- Medigap plans are optional. You should check first to see if you already have union or employer coverage to help cover the costs Original Medicare does not cover. Otherwise, you can choose to obtain a Medicare Supplement Plan to cover the costs Medicare Part A and Part B does not cover.
- What should I know about Medicare Part A and Part B?
- Every year, you typically pay a deductible before Medicare begins to pay its share. When Medicare pays its share, you then pay coinsurance for covered supplies and services. For Medicare Part B, you typically pay a monthly premium. Suppliers and providers are required to file Medicare claims for supplies and services you receive so you typically do not need to file Medicare claims.
What is not covered by Medicare Part A and Part B?
Typically, Original Medicare does not cover prescription drugs. There are exceptions such as transplant patients needing immunosuppressive drugs or cancer drugs. Other items not covered under Original Medicare are dentures, cosmetic surgery, eyeglasses, hearing aids and much more.
Is there a cost to Medicare Part A and Part B?
Typically, you pay a monthly premium for Medicare Part B. The cost will vary based upon your income. Generally, there is no monthly premium for Medicare Part A, depending upon whether Medicare taxes were paid while working.
Medicare Part A and Part B assignment
Medicare Part A and Part B pays for supplies and health care services via a process called assignment. Assignment is when your medical product supplier, doctor or health care provider accepts the full amount of payment for supplies or services from the Medicare approved amount. When you can get supplies and services from anyone who accepts a Medicare assignment, this will reduce your costs.
Visit Medicare.gov to find suppliers or doctors who accept assignment or call 1-800-MEDICARE (1-800-633-4227) (TTY users 1-877-486-2048),