Original Medicare: What it Does and Doesn’t Cover
Original Medicare includes two parts: A and B. The reason it is called Original Medicare is
Medicare Part A helps pay for medically necessary care that requires a stay in the hospital or at a skilled nursing facility. It also covers hospice care for the terminally ill and some skilled home health care.
Medicare Part A is free if you or your spouse have paid into Social Security for 10 or more years. However, it does come with a deductible per hospital stay for each “benefit period.” This period begins when you are admitted to the hospital and ends when you have been out of the hospital for 60 days in a row. After that, what you pay changes depending on the length of your stay.
| Length of Hospital Stay | You Pay |
| Days 1-60 | $1,408 deductible, then nothing |
| Days 61-90 | $352 per day |
| Days 91-150 | $704 per each “lifetime reserve day” for each benefit period (up to 60 days over your lifetime) |
| After 150 Days | Full cost of your hospital stay |
| No limit on out-of-pocket costs | |
Source: Medicare.gov.
Medicare Part B helps pay for medical care, including doctor office visits, lab tests and screenings, and some skilled nursing care at home, as well as the doctor services you receive when you are in the hospital.
Medicare Part B comes with a small deductible. You must also pay a monthly premium for Part B, which increases based on your income.
| Medicare Pay | You Pay |
| 80% of medical care costs (once deductible is met) | $198 Deductible |
| $144.60 monthly premium* | |
| 100% of the cost of prescription drugs | |
| 20% of all medical care | |
| No limit on out-of-pocket costs | |
Source: Medicare.gov.
*Can vary based on income and potentially how long you’ve been enrolled in the Medicare program.
