Medicare Part A & B (Original Medicare)
Background on Original Medicare (Medicare Part A and B)
Part A and Part B are often referred to as "Original Medicare". Original Medicare is managed by the Federal government and lets people with Medicare go to any doctor, hospital, or other health care provider who accepts Medicare. It is a fee-for-service plan, meaning that the person with Medicare usually pays a fee for each service. Medicare pays its share of an approved amount up to certain limits, and the person with Medicare pays the rest.
The Centers for Medicare & Medicaid Services (CMS) is the Federal agency that runs Medicare. CMS is part of the U.S. Department of Health and Human Services. Medicare is financed by a portion of the payroll taxes paid by workers and their employers. It also is financed in part by monthly premiums deducted from Social Security checks.
What is Not Covered by Original Medicare?
Original Medicare doesn't cover everything. For example, it doesn't cover cosmetic surgery, health care you get while traveling outside of the United States (except in limited cases), hearing aids, most hearing exams, long-term care (like care in a nursing home), most eyeglasses, most dental care and dentures, and more. Generally, Original Medicare does not cover prescription drugs, although it does cover some drugs in limited cases such as immunosuppressive drugs (for transplant patients) and oral anti-cancer drugs. Some of these services not covered by Original Medicare may be covered by a Medicare Advantage Plan (like an HMO or PPO).
How Much Does Original Medicare Cost?
People usually don't pay a monthly premium for Part A coverage if they or their spouse paid Medicare taxes while working. For Part B, most people pay a standard monthly premium ($96.40 in 2009; $110.50 in 2010*). Some people may pay a higher Part B premium based on their income.
Medicare Part B (Medical Insurance)
Medicare Part B helps cover medically-necessary services like doctors' services, outpatient care, and other medical services. Part B also covers some preventive services. These include a one-time "Welcome to Medicare" physical exam, bone mass measurements, flu and pneumococcal shots, cardiovascular screenings, cancer screenings, diabetes screenings, and more.