Original Medicare is broken into two parts: Part A (Hospital Insurance) and Part B (Medical Insurance). For most individuals, Part A is free based on your (or a spouse's) work history in the United States. Medicare Part B has a monthly premium of $174.70 (2024). However, higher income earners could have a higher premium due to the Medicare Income-Related Monthly Adjustment Amount (IRMAA). 

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Medicare is Federal program designed for people age 65 years old or over or individuals with certain disabilities. Individuals collecting Social Security Disability Insurance (SSDI) will also be automatically enrolled into Medicare after 24 months. 

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With more and more individuals working past 65, the decision to take Medicare Part B (remember Part A is free!) becomes challenging. There are many factors to consider. At HEALTHFOCUS PARTNERS we look at the costs vs. benefits of your options.

 

Some individuals may be required to take Medicare Part B or face a lifelong Part B Late-Enrollment Penalty. This could be due to not having creditable coverage elsewhere or working at an employer with less than 20 employees. We'd be happy to go over the complex rules and help provide guidance on your options so you can feel confident in your decision. 

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A lot people associate Medicare with an 80/20 rule; Medicare paying 80% of the costs. While this is somewhat true, it's more complex than this simple rule. Medicare Part A has deductibles, copayments, and coinsurances that vary based on you length of stay in an inpatient setting. Medicare Part B has an annual deductible ($226 in 2023) and then Medicare pays 80% of covered services. Because of these holes/gaps in Original Medicare coverage, many individuals look at either supplementing Original Medicare with a Medigap policy or replacing it through a private insurer with a Medicare Advantage/Part C plan.

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Original Medicare by itself does NOT cover the following: prescriptions, dental, vision, or hearing services. 

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Check out the resources above. If you still have questions relating to Original Medicare, please reach out. We'd be happy to provide guidance (psssst.... it's free!)