What Is Original Medicare
(Parts A and B)?
Medicare is a federal health-care program that provides benefits to senior citizens and people with disabilities or certain medical conditions. Original Medicare refers to Medicare Parts A and B, which the federal government administers.
Part A Medicare
Medicare Part A is a type of Medicare that pays for hospital care and inpatient services. There are many options of Part A depending on how many quarters of medicare taxes you have paid. You could pay $0 with a premium-free plan, or up to $499 with a premium plan. Your payments could be higher if you do not enroll on time.
According to the Centers for Medicare and Medicaid Services, Part A covers the following benefits and more:
- Skilled nursing services
- Lab tests and x-rays for inpatient care
- Hospice care for terminally ill patients
- Part-time skilled home health-care services
- A semi private hospital room and hospital meals
- Inpatient or outpatient rehabilitation following a hospital stay
- Treatment in special hospital units, such as intensive care
Part B Medicare
Medicare Part B provides coverage for care that you receive at a clinic, as well as outpatient treatment at a hospital. The premium for Part B can range from $170.10 to $504.90 per month. Depending on your situation, you could pay higher or lower premiums.
According to the Centers for Medicare and Medicaid Services, Medicare Part B covers the following benefits:
- Doctor visits
- Annual wellness visits
- Mental health care
- Skilled nursing services
- Ambulance and emergency room services
- Durable medical equipment for home use, such as wheelchairs
- Physical therapy, occupational therapy, and speech-language pathology sessions
Is Original Medicare Coverage Enough?
Medicare plans are unique. While Parts A and B may provide enough coverage for some people, but Original Medicare is not sufficient to meet everyone’s needs. That’s why it’s important to explore supplemental plans with a licensed Medicare agent.
Is Original Medicare Coverage Enough?
Original Medicare covers many important medical expenses. Part A covers inpatient services and hospital stays, while Part B provides benefits for important outpatient needs.
However, many people have unique needs that Original Medicare does not cover. For example, Parts A and B do not provide benefits for prescription drugs. Dental, vision, and hearing plans are not available under this coverage.
You could receive benefits if you enroll in Medicare Part D, which is a supplemental drug plan. Dental and vision benefits are available with certain Medicare Advantage plans, which private insurance carriers offer.
Are You Liable for Any Expenses?
Yes, you are liable for expenses on Original Medicare. This coverage only provides benefits for a limited time. You will need to pay co-pays for any treatment that you receive after the coverage ends.
For example, Part A only covers the first sixty days of a hospital stay. If you need care from days sixty-one to ninety, you’ll have a co-pay of $389 per day. The co-pay is $778 per day for any treatment after ninety days.
These expenses could add up quickly, especially if you have a serious medical condition that requires ongoing care.
In these situations, it is important to invest in additional forms of coverage, like Medicare Advantage plans and Medicare supplements. These policies provide additional coverage plus unique benefits.
Depending on the supplemental plans that you select, you could close critical gaps in coverage. A licensed agent from Sunnyside Medicare can evaluate your needs and identify ways to limit your out-of-pocket costs.
Original Medicare Enrollment
For most people in Michigan, Medicare Part A and Part B enrollment opens a few months before their sixty-fifth birthday. However, there are some people who do not need to enroll at all.
When Does Initial Enrollment for Medicare Open?
The initial enrollment period for Medicare opens three months before you turn sixty-five years old. Medicare enrollment remains open during your birthday month and closes three months later.
For example, say that you are turning sixty-five on March 8. Your initial enrollment period will open on December 1, remain open during the month of March, and close on June 30.
You can enroll for Medicare online, over the phone, or by visiting your Social Security Administration (SSA) office in Michigan. Medicare enrollment assistance is available at Sunnyside Medicare.
What If I Already Get Social Security Benefits?
If you receive Social Security benefits, you do not need to enroll in Medicare. The government will take care of your enrollment automatically.
You could qualify for Medicare enrollment before age sixty-five if you receive Social Security disability benefits. If you have received Social Security Disability Insurance (SSDI) or Railroad Retirement benefits for at least twenty-four months, you are eligible for Medicare.
Why Is It Important to Enroll in Medicare on Time?
If you do not enroll in Medicare during this time, you could face significant penalties.
- The Part A enrollment penalty is 10 percent of the premium. You will need to pay these penalties plus your monthly premium for twice the number of years that you delayed enrollment. For example, if you delay enrollment for two years, you will pay an additional 10 percent on your premium for four years.
- The Part B enrollment penalty is also 10 percent of your monthly premium for each twelve-month period that you delay coverage. You will need to pay this penalty for as long as you have Medicare Part B. For example, if you delay enrollment for four years, you will need to pay 40 percent of your premium plus the normal monthly amount.
It’s important to enroll on time when it comes to Medicare. Michigan residents can save money and avoid these penalties by starting their Medicare plan around their sixty-fourth birthday.
Prepare to Sign Up for Medicare in Michigan
When it comes to Original Medicare, it pays to prepare in advance. By the time the initial enrollment period opens, you should know your options for Michigan Medicare and the custom plan that works best for you.
The Medicare landscape can be difficult to navigate alone. In these situations, you need the experts at Sunnyside Medicare on your side. Our licensed Medicare agents provide personalized care and dedication from consultation to enrollment and beyond.
If you need Medicare support, trust the best to guide you through the process. Contact Sunnyside Medicare today and experience the Sunnyside difference for yourself.
Looking for a Helping Hand?
Call us at 1-248-277-5948 to talk with a Sunnyside Agent. Our licensed Medicare Agents are friendly, knowledgeable and always willing to take the time to find the right plan for you! Not ready to talk on the phone? Send us an online message and an Agent will get back to you shortly. We look forward to helping you.