Medicare Basics | Alight Retiree Health

What is Original Medicare?

Medicare is a health insurance program for people age 65 or older. People younger than 65 can also qualify for Medicare, including those with disabilities and permanent kidney failure.

Created in 1965 as a government program, Original Medicare started with Part A and Part B. Later, Part C and Part D were added as the needs of Medicare beneficiaries changed.

Orignal Medicare

Original Medicare Parts A and B help pay for hospital stays and doctor visits, but it doesn’t cover everything.

What’s covered
Part A: Hospital Coverage
  • Inpatient hospital care
  • Inpatient care in a skilled nursing facility
  • Hospice care
  • Home health care
Part B: Medical Coverage
  • Medically necessary services (services or supplies to diagnose or treat a condition that meets accepted standards of medical practice)
  • Preventive care (health care to prevent illness or detect it at an early stage, when treatment is most likely to work best)
  • Doctor visits
  • Outpatient hospital care
  • Durable medical equipment and supplies
What’s not covered
  • Most prescription drugs
  • Long-term care (also referred to as Custodial care)
  • Most dental care
  • Eye exams related to prescribing glasses
  • Dentures
  • Cosmetic surgery
  • Acupuncture
  • Hearing aids and exams for fitting them
  • Routine foot care

Even if a service or item is covered, you’ll generally have to pay deductibles, coinsurance or copays without any annual limit on those costs.

There is no out-of-pocket maximum for Original Medicare Parts A and B, which means your share of costs is unlimited. Enrolling in an individual Medicare insurance plan can help protect your pocketbook.

Supplemental plans can help cover these costs. Learn more

Who qualifies?

You must be age 65 or older, a U.S. citizen or a permanent U.S. resident and have lived in the U.S. continuously for five years prior to applying.

You can be younger than 65 with a qualifying disability. You have been diagnosed with end-stage renal disease or amyotrophic lateral sclerosis (ALS; also known as Lou Gehrig's disease) at any age.

You should be automatically enrolled in Original Medicare if you’re already receiving Social Security or Railroad Retirement Board benefits when you become eligible. If you’re not receiving either of these benefits, you need to sign up with Social Security to get Original Medicare Parts A and B when you become eligible.

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