Medicare is a government-run health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD). In this blog post, we will discuss what Original Medicare is in 2022. Also, we will cover Part A and Part B of Original Medicare, and explain how they work. Stay tuned for our next blog post, which will cover Part C and Part D of Original Medicare!
How Does Medicare Work?
Part A and B make up Original Medicare. Part A covers hospital insurance, while Part B covers medical insurance. Secondly, you can choose to enroll in both parts, or just one part. If you decide to enroll in both parts, you will need to pay a monthly premium for Part B.
What Does Part A Cost?
Original Medicare in 2022 Part A has no monthly premium for most people. If you are not eligible for premium-free Part A, you will need to pay a monthly premium. Below you will see a breakdown of what the pay schedule looks like
Premium $0.00 for most if applicable up to $499.00 per month in 2022
Deductible $1556.0 in 2022 per benefit period
Copayment :
Hospital Days 1-60 you pay $0.00
Days 61-90 $389.00 per day
Days 91 and beyond: $778.00 Per day up to 60 lifetime Reserve days
Skilled Nursing Facility(per benefit period)
Days 1-60 $0.00
On Days 61-90 $194.50 per day in 2022
Days 91 and Beyond: You pay all costs
Hospice
Medications for pain and symptom management: Up to $5.00 per subscription.
Durable medical equipment used at home; and respite care:
Home hospice patients may pay a small coinsurance amount for inpatient respite care or durable medical equipment used at home.
*Lifetime reserve days are a set number of covered hospital days you can draw on if you’re in the hospital longer than 90 days. You have 60. Each lifetime reserve day may be used only once, but you may apply the days to different benefit periods. Lifetime reserve days may not be used to extend coverage in a skilled nursing facility.
What Does Part A Cover:
Hospital stays and inpatient care, including:
- A semi-private room
- Hospital meals
- Skilled nursing services
- Care in special units, like intensive care
- Drugs, medical supplies and medical equipment used during an inpatient stay
- Lab tests, X-rays and medical equipment used as an inpatient
- Operating room and recovery room services
- Operating room and recovery room services
- Some blood transfusions in a hospital or skilled nursing facility
- Inpatient or outpatient rehabilitation services after a qualified inpatient stay
- Part-time, skilled care for the homebound
What is not Covered by Part A?
- Personal expenses while hospitalized, like a TV or phone service
- Most care outside of the United States
- Custodial care (care that helps with daily life activities, like eating and bathing)
- Long-term care
- Days spent in a psychiatric hospital beyond certain set limits
- Hospital stays beyond certain set limits
What Does Part B Cost in Original Medicare in 2022?
The standard Part B premium amount is $178.10 in 2022. Most people pay the standard premium amount. If your modified adjusted gross income as reported on your IRS tax return from two years ago is above a certain amount, you may pay an Income-Related Monthly Adjustment Amount (IRMAA).
Keep in mind, Part B has an annual deductible of $233.00 in 2022.
What Does Part B Cover?
Part B covers:
- Doctor’s services and outpatient care, including:
- Preventive services to keep you healthy and to prevent illness, like screenings and shots
- Mental health care
- Ambulance Services
- Durable medical equipment (like walkers, wheelchairs, and hospital beds)
- Part-time skilled nursing care
- Physical and occupational therapy
- Some home health services
- Outpatient mental health services
What is not Covered by Part B?
Part B does not cover:
- Custodial or long-term care (care that helps with daily living activities like eating and bathing)
- Most dental care, routine eye exams, glasses, and hearing aids
- Acupuncture
- Cosmetic surgery
- Private-duty nursing
Now that you know what Part A and Part B cover, let’s take a look at what Medigap plans are.
A Medigap plan is a health insurance policy that is sold by private insurance companies to fill the “gaps” in original Medicare coverage.
This means that a Medigap policy helps pay for some of the out-of-pocket costs that are not covered by Medicare, like:
- Copayments
- Coinsurance
- Deductibles
Medigap plans are only available to people who have Medicare Part A and Part B.
If you have a Medigap policy, it will pay second after Medicare. This means that Medicare in 2022 will pay its share of the approved amount for covered health care costs first, and then your Medigap policy will pay its share.
Also, You can use any doctor or hospital that accepts Medicare.
There are ten standardized Medigap plans available in most states, each identified by a letter. That being said the most popular plans to focus on are the G and N Plan.
What is the G Plan?
Plan G pays for:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- The first three pints of blood each year
- Part A hospice care coinsurance or copayment
- Skilled nursing facility care coinsurance
- Part B deductible
- 80% of Part B excess charges
What is the N Plan?
Plan N pays for:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- The first three pints of blood each year
- Part A hospice care coinsurance or copayment
- Skilled nursing facility care coinsurance
- Part B deductible
- 50% of Part B excess charges
In summary, Medicare’s costs and out of pockets can be very intimidating. That’s why we recommend connecting with us so we can explain what plan helps you absorb those costs and keeps your budget intact.
