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 that Parts A and B used to be the only Medicare coverage available until they added Part C (Medicare Advantage) and Part D (prescription drugs) later on.


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 StayYou 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 DaysFull 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 PayYou 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.


Interested in Learning More About a Sparrow Advantage (HMO-POS) Plan?

Talk with a Licensed Medicare Advisor

Talk with a Licensed
Medicare Advisor

Discuss your options with a local, licensed Sparrow Advantage Medicare advisor.

Attend a FREE Medicare Seminar

Attend a FREE
Medicare Seminar

Learn more about Sparrow Advantage plans at one of our FREE Medicare seminars.

Request Your FREE Information Kit

Request Your FREE
Information Kit

Download your FREE Medicare Information Kit or request a physical copy in the mail.

Schedule a Personal Consultation

Schedule a
Personal Consultation

Get all your questions answered in a one-on-one appointment with a licensed Medicare advisor.

Attention


You are about to leave the PHP Advantage plan site and visit the PHP Health System website.


To continue, click on the link below. Otherwise, close this window to remain on the current site.


Continue to PHPMichigan.com


Attention


You are about to leave the Essence Healthcare plan site and visit the Center for Medicare & Medicaid Services (CMS) website.


To continue to this site, click on the link below. Otherwise, close this window to remain on the current site.


Visit CMS.gov.


+
ENROLL NOW