{"id":53360,"date":"2022-10-11T21:28:34","date_gmt":"2022-10-12T01:28:34","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=53360"},"modified":"2026-01-15T16:18:33","modified_gmt":"2026-01-15T21:18:33","slug":"what-is-original-medicare","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/what-is-original-medicare\/","title":{"rendered":"What is Original Medicare?"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Original Medicare is federal health insurance for Americans who are 65 years old or older. You may be able to receive Medicare benefits before you turn 65 if you have Lou Gehrig&#8217;s disease or End-Stage-Renal Disease or if you have received Social Security Disability Insurance (SSDI) benefits for more than 24 months.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medicare-parts\/\"><span style=\"font-weight: 400;\">four parts of Medicare<\/span><\/a><span style=\"font-weight: 400;\">:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-medicare-part-a\/\"><span style=\"font-weight: 400;\">Medicare Part A<\/span><\/a><span style=\"font-weight: 400;\"> is hospital insurance.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-medicare-part-b\/\"><span style=\"font-weight: 400;\">Medicare Part B<\/span><\/a><span style=\"font-weight: 400;\"> covers outpatient care and medical services.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-medicare-advantage\/\"><span style=\"font-weight: 400;\">Medicare Part C<\/span><\/a><span style=\"font-weight: 400;\"> is an alternative way to receive your Medicare benefits through private insurance plans.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-medicare-part-d\/\"><span style=\"font-weight: 400;\">Medicare Part D<\/span><\/a><span style=\"font-weight: 400;\"> is coverage for prescription drugs.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Original Medicare includes Parts A and B. Part D is an optional stand-alone prescription plan for people with Original Medicare.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To find out if you have both parts of Original Medicare, you can review your red, white, and blue Medicare card, check online at either<\/span> <a href=\"https:\/\/www.medicare.gov\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">medicare.gov<\/span><\/a><span style=\"font-weight: 400;\"> or<\/span> <a href=\"https:\/\/www.ssa.gov\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">ssa.gov<\/span><\/a>,<span style=\"font-weight: 400;\"> or call Medicare or The Social Security Administration. If you are enrolled in Medicare Part C or Part D, you will receive separate insurance cards for those programs.<\/span><\/p>\n<h3 id=\"part-a\"><span style=\"font-weight: 400;\">Part A\u00a0<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Medicare Part A covers services that include the following:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Inpatient hospital care<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Inpatient care in a skilled nursing facility that&#8217;s not custodial or <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/news\/long-term-care-statistics\/\"><span style=\"font-weight: 400;\">long-term care<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hospice care<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Home health care<\/span><\/li>\n<\/ul>\n<h3 id=\"part-b\"><span style=\"font-weight: 400;\">Part B<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Medicare Part B covers the following:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Doctor visits<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Preventive services<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Outpatient services<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diagnostic laboratory tests<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Durable medical equipment<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Drugs administered in the physician&#8217;s office<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Outpatient surgeries<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Outpatient imaging tests: X-rays, MRIs, CT scans, ultrasounds, etc.<\/span><\/li>\n<\/ul>\n<h3 id=\"part-d\"><span style=\"font-weight: 400;\">Part D<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Medicare Part D covers the following:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/what-drugs-are-covered-by-medicare-part-d\/\"><span style=\"font-weight: 400;\">Many prescription drugs<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/medicare-vaccine-coverage\/\"><span style=\"font-weight: 400;\">Some vaccines<\/span><\/a><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Medicare Part D is optional prescription drug coverage for people with Original Medicare. However, if you enroll in Original Medicare without Part D and you do not have creditable drug coverage, you will pay a <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medicare-part-d-penalty\/\"><span style=\"font-weight: 400;\">late enrollment penalty<\/span><\/a><span style=\"font-weight: 400;\"> if you add a Part D plan after your Initial Enrollment Period.<\/span><\/p>\n<h3 id=\"what-is-not-covered\"><span style=\"font-weight: 400;\">What is not covered<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">For healthcare services and procedures to be covered by Original Medicare, they must be considered medically necessary. In addition to being medically necessary, the procedures must be approved by the FDA. Some items that Original Medicare doesn&#8217;t cover will include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Routine dental coverage<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vision coverage<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hearing aids<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Cosmetic surgery<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Prescription drug coverage<\/span><\/li>\n<\/ul>\n<h2 id=\"how-much-does-original-medicare-cost\"><span style=\"font-weight: 400;\">How much does Original Medicare cost?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">In 2026, Original Medicare will cost $202.90 or more per month. The cost of Original Medicare depends on how long you or your spouse worked (Part A), your reported income from two years ago (Part B), and whether you have a Part D plan. In addition to a monthly premium, you\u2019ll owe a deductible before each part of Medicare begins to cost-share and a copay\/coinsurance for covered medical services. See the breakdown of costs below.\u00a0<\/span><\/p>\n<h3 id=\"part-a-costs\"><span style=\"font-weight: 400;\">Part A costs<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Medicare Part A is premium-free for most beneficiaries. As long as you or a spouse worked at least 40 quarters (10 years) throughout your lifetime, you&#8217;ll receive Medicare Part A at no monthly cost.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you worked less than 40 quarters, you might still be able to receive Medicare Part A, but you&#8217;ll pay a monthly premium of $311\u2013$565 per month, depending on your work history.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Your premium will depend on how long you or a spouse worked and paid into Medicare taxes.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You also have other costs associated with Medicare Part A. Here are the Part A costs for 2026:<\/span><\/p>\n<p><b>Hospital stay:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">$1,736 deductible for each benefit period<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">$0 for the first 60 days of inpatient hospital care per benefit period<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">$434 per day for days 61\u201390 of inpatient hospital care per benefit period<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">$868 per lifetime reserve day.<\/span>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">After day 90 of inpatient care per benefit period (Medicare enrollees have a maximum of 60 reserve days in their lifetime)<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><b>Skilled nursing facility (SNF) stay:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">$0 for the first 20 days of inpatient SNF care per benefit period<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">$217per day for days 21-100 of inpatient SNF care per benefit period<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">All costs for each day after day 100 of inpatient SNF care in the benefit period<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">A benefit period measures your use of a hospital or SNF. A benefit period begins the first day that you are admitted to a hospital or SNF and ends when you have not received inpatient care for 60 days in a row. The costs above may vary if you have a Medigap plan, Medicare Savings Program, or Medicaid.\u00a0<\/span><\/p>\n<h3 id=\"part-b-costs\"><span style=\"font-weight: 400;\">Part B costs<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The monthly premium for Medicare Part B in 2026 for most beneficiaries is $202.90. The monthly premium may be higher depending on your reported income from two years prior.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In addition to the premium, there are additional costs when using Medicare Part B.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">$283 annual Medicare Part B deductible<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">20% coinsurance if your healthcare provider accepts Medicare assignment<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">15% excess charges above Medicare\u2019s approved amount if your healthcare provider does not accept Medicare assignment (in some states)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Once you meet the Medicare Part B deductible, Medicare will pay 80% of the Medicare-approved amount, leaving you with 20% coinsurance.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Some healthcare providers don&#8217;t accept Medicare assignments in these cases and can charge you an additional 15% above the Medicare-approved amount in some states.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Medicare beneficiaries may enroll in Medicare supplemental insurance (Medigap) to help cover the out-of-pocket cost-sharing associated with Original Medicare.<\/span><\/p>\n<h3 id=\"part-d-costs\"><span style=\"font-weight: 400;\">Part D costs<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The monthly premium for Medicare Part D varies by plan, but the national benchmark premium for 2026 is $38.99 per month. There are <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medicare-donut-hole\/\"><span style=\"font-weight: 400;\">various coverage stages<\/span><\/a><span style=\"font-weight: 400;\"> that may affect your cost for covered prescriptions throughout the year:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The Part D deductible ranges from $0 to $615, depending on the plan.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">After you meet the plan\u2019s deductible, you\u2019ll be responsible for paying a copay or coinsurance (also determined by your specific plan).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">After you and the insurance company have spent a combined amount of $2,100, you\u2019ll pay 0% of drug costs.\u00a0<\/span><\/li>\n<\/ul>\n<h2 id=\"original-medicare-vs-medicare-advantage\"><span style=\"font-weight: 400;\">Original Medicare vs. Medicare Advantage<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Medicare Advantage plans (Medicare Part C) are an alternative way to receive your Medicare benefits.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">These private health insurance plans must cover the same benefits as Original Medicare, and the coverage must be as good or better than Original Medicare.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">These plans are regulated by the Centers for Medicare &amp; Medicaid Services but are administered by private insurance companies.<\/span><\/p>\n<p><b>Coverage:<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Medicare Advantage plans frequently include prescription drug coverage and possibly some extra benefits not covered by Original Medicare.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Medicare Advantage plans will differ depending on where you live and which insurance company you choose.<\/span><\/p>\n<p><b>Cost:<\/b><\/p>\n<p><span style=\"font-weight: 400;\">The costs associated with a Medicare Advantage plan can vary as well. There is typically a low monthly premium and, in some cases, a $0 premium. There will be fixed, predictable copays for most services. An additional benefit is that Part C plans have a limit on out-of-pocket costs, unlike Original Medicare.<\/span><\/p>\n<p><b>Limitations:<\/b><\/p>\n<p><span style=\"font-weight: 400;\">There are also some drawbacks to Medicare Advantage, such as potential denial of care, a limited network of healthcare providers, a prior approval requirement for services, and Original Medicare no longer administering your healthcare benefits.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you are unsure about which program may best meet your needs, call <\/span><span style=\"font-weight: 400;\">1-800-MEDICARE <\/span><span style=\"font-weight: 400;\">or seek out a state health insurance assistance program, area agency, or nonprofit that specializes in Medicare.<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-original-medicare\/\"><b>How to choose between Original Medicare vs. Medicare Advantage<\/b><\/a><\/p>\n<h2 id=\"how-to-save-money-on-original-medicare-related-costs\"><span style=\"font-weight: 400;\">How to save money on Original Medicare-related costs<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Medicare may still be expensive, and there are many programs that can help with cost-sharing.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">For those beneficiaries with low income, you can look into the Low-Income Subsidy Program or <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medicare-extra-help\/\"><span style=\"font-weight: 400;\">Extra Help<\/span><\/a><span style=\"font-weight: 400;\">. This program assists with the costs of prescription drug plan premiums, deductibles, copays, and coinsurance.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">A <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medicare-savings-program\/\"><span style=\"font-weight: 400;\">Medicare Savings Program<\/span><\/a><span style=\"font-weight: 400;\"> can also assist low-income Medicare beneficiaries with help paying for their Original Medicare premiums, deductibles, copays, and coinsurance for medical services.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Other ways to save on prescription drug costs (whether you have Part D or not) include <\/span><a href=\"https:\/\/www.singlecare.com\/prescription-discount-card\"><span style=\"font-weight: 400;\">discount cards<\/span><\/a><span style=\"font-weight: 400;\"> like SingleCare. SingleCare has no fees and provides a discount of up to 80% on prescriptions. However, you\u2019ll have to use SingleCare <\/span><i><span style=\"font-weight: 400;\">instead<\/span><\/i><span style=\"font-weight: 400;\"> of Medicare. Prescriptions purchased with a SingleCare discount card will not apply to your Part D deductible.<\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Original Medicare is federal health insurance for Americans who are 65 years old or older. You may be able to receive Medicare benefits before you turn 65 if you have Lou Gehrig&#8217;s disease or End-Stage-Renal Disease or if you have received Social Security Disability Insurance (SSDI) benefits for more than 24 months. There are four [&hellip;]<\/p>\n","protected":false},"author":133,"featured_media":53362,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2],"tags":[608,691,15],"coauthors":[20918],"class_list":["post-53360","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-company","tag-health-insurance","tag-healthcare-costs","tag-medicare","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>What is Original Medicare? | SingleCare<\/title>\n<meta name=\"description\" content=\"Original Medicare is one way to enroll in Medicare benefits. 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