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Traditional Medicare Coverage

Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities, and any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant).
 
Traditional Medicare is provided by the federal government and includes Part A and Part B coverage.
 
Part A is your hospital insurance and helps cover services such as: 
  • Inpatient care in hospitals (includes inpatient rehabilitation facilities)
  • Inpatient stays in a skilled nursing facility (not custodial or long term care)
  • Hospice care services
  • Home health care services

There is usually not a monthly premium for Part A coverage if you or your spouse paid Medicare taxes while working. If you aren’t eligible for premium-free Part A, you should review theMedicare and You guide provided by Medicare to learn more about your options.

There are various deductibles associated with Part A and the deductible amounts usually change from year to year. You can get more information about Part A deductibles by reviewing the Medicare and You guide at www.medicare.gov.

Part B is your medical insurance and helps cover medically necessary services like doctors’ services, outpatient care, and other medical services. Part B also covers some preventive services.

Part B does have a monthly premium. Most people will pay the standard premium amount of $104.90.  This amount may change in 2016. You also pay a Part B deductible each year before Medicare starts to pay its share. In 2015, the deductible amount is $147 per year and may change in 2016.

Important Facts About Traditional Medicare

  • Part A is hospital insurance. Part A helps cover inpatient care in hospitals, skilled nursing facilities, hospice, and home health care.
  • Part B is medical insurance. Part B helps with doctors’ costs, hospital outpatient care, and home health care.
  • On the first day of the month you turn 65, you will automatically receive Medicare Part A and B coverage. However, you can opt out of Part B coverage.
  • Care outside the United States is not covered.
  • You must pay a deductible before Part A starts covering hospital stays.