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Original Medicare

Original Medicare

Original Medicare is a fee-for-service health plan that has two parts: Part A (Hospital Insurance) and Part B (Medical Insurance). After a deductible is paid, Medicare pays its share of the Medicare-approved amount, and the beneficiary pays their share (coinsurance and deductibles).

Original Medicare is a fee-for-service health plan that has two parts: Part A (Hospital Insurance) and Part B (Medical Insurance). After a deductible is paid, Medicare pays its share of the Medicare-approved amount, and the beneficiary pays their share (coinsurance and deductibles).

  • Original Medicare is the federally funded healthcare program that provides coverage for millions of seniors and disabled individuals in the United States. It is administered by the CMS and consists of two main parts: Part A (hospital insurance) and Part B (medical insurance).
  • Part A of Original Medicare covers inpatient hospital care, SNF care, hospice care, and some home healthcare services. Part B covers outpatient medical services, such as doctor’s visits, preventive care, and some home healthcare services.
  • One of the key features of Original Medicare is that it is a fee-forservice program, which means that beneficiaries pay a deductible and copayment for each service received. There are also limits on how much Medicare will pay for certain services, and beneficiaries may be responsible for paying any remaining costs out of pocket.
  • While Original Medicare provides a wide range of coverage, it does not cover everything. For example, it does not cover most prescription drugs, dental care, or long-term care. Beneficiaries can choose to purchase a separate Medicare Part D plan to cover prescription drugs, and they may also consider purchasing a Medicare supplement (Medigap) policy to help cover some of the out-of-pocket costs associated with Original Medicare.
  • Overall, Original Medicare is an important source of healthcare coverage for seniors and disabled individuals, but it is important for beneficiaries to understand its limitations and consider whether additional coverage may be necessary to meet their healthcare needs.

Understanding the limiting charge is crucial for Medicare beneficiaries to avoid unexpected out-of-pocket costs when seeking care from providers who don't accept Medicare assignment.

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