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Original Medicare is comprised of two components. Part A for hospitals and emergency rooms, which was paid for with taxes and has no monthly premium. Part B is for Doctors and Specialists visits and is paid for by a monthly premium. There is no Prescription Coverage under original Medicare. Most of Original Medicare, you pay 20% and Medicare pays 80% with no maximum out of pocket to protect you. Come see us to learn more details about how it works and why there are more plans beyond original Medicare.
This is going to be the first and probably last stop for Social Security when dealing with Medicare. You go to the Social Security Administration to sign up for Original Medicare. After that, you will deal primarily with Centers for Medicaid and Medicare Services AKA 1-800-Medicare. Then if you decide to get a plan beyond Original Medicare, your plan will most likely be the primary contact.
Part A is automatic at age 65 and older or if you have received 24 months of social security disability. Medicare Part A is also known as hospital insurance. It covers various types of inpatient care.
Part A covers Hospital and Emergency room, but not ambulance. Like most things under Original Medicare, you pay 20% and Medicare pays 80%. The exception in Part A is Hospice care.
There are several specifics, however this is the oversimplified version.
Part B requires an application because it has a premium. That premium usually goes up a little bit every year, however sometimes when prescriptions or procedures come down in price it can also reduce the next years premium which happened recently when an expected Prescription increased it but then was not approved, so they reduced it the following year. It tends to move about the same as the Cost of Living Adjustment that Social Security has each year.
Once you have Part B, you have more comprehensive coverage. You can visit specialists and doctors that take Medicare. There is also preventative services in which you do not have a 20% coinsurance. It is Important to remember that although Medicare does not have a network, not all doctors accept Medicare. They have a choice in what they accept for a plan, so it is always important to see if your doctor takes your coverage, no matter what coverage you have.
Some Prescription Drugs are Part B drugs and Part D Drugs, and the difference is how they are administered or the way the cost is processed. Although it may be expensive, the cost is supposed to be run at the lowest price to the consumer. Most of the time these prescriptions are biologics administered through infusions. Sometimes the only place that can administer them near you may be a hospital, in which case they may have the lowest price option as an outpatient visit. To figure out which way it was billed you have to contact the provider or Medicare.
Part A covers Hospital and Emergency room, but not ambulance. Like most things under Original Medicare, you pay 20% and Medicare pays 80%. The exception in Part A is Hospice care.
There are several specifics, however this is the oversimplified version. Please call us or come by to learn more!
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