Do I Stay With Original Medicare and What's the Cost

This addresses our second question in the Map to Medicare.  We just covered When Do I Enroll In Medicare. Now it's time to move toward what choices you have.

Once you have answered #1 and have enrolled in A and B, it’s good to understand exactly what Original Medicare covers and what it costs.

After you enroll, and in two to three weeks, you will get a letter advising you of your start dates for A and B. A few days after the letter, your card will arrive. Here is a sample.

That alpha numeric under your name is your Medicare number and below that are your A and B start dates.

What are the premiums? If you or your spouse have paid into Medicare for 40 quarters, there is no premium for A. For B, the base premium is $148.50. This is the 2021 number. But premiums are only part of the cost.

What if you just want to stay with Original Medicare? You aren’t interested in either a Medicare Advantage or a Medigap/Supplement plan. If so, here is what you need to know about that choice.

Part A has a deductible of $1484. This is not a yearly deductible, but one with a 60 day benefit period. Here is a scenario. After your Medicare coverage starts, you have an issue and are hospitalized. Upon admission, you will be billed $1484- the deductible. After 2 days they discharge you. 60 days later you are readmitted into the hospital. Since the 2^nd admission is over 60 days from the first discharge, you pay the $1484 again. This could happen a few more times. Could be expensive, right?

For Part B, there is a yearly deductible of $203, and once that is paid you have satisfied the deductible. Not so bad compared to the Part A deductible.

If you are thinking about the expense of Part A’s 60 day benefit period, you may wonder if there is a Max Out of Pocket, or MOOP, that would put a cap on your out of pocket deductibles, copays and coinsurance. Sorry, but Original Medicare has no MOOP.

Let’s look at the Original Medicare highlights, assuming you have no Part A premium.

Part A Deductible of $1484 for 60 day benefit Period
Part B Deductible of $203 yearly
No Max Out of Pocket
Part B co-insurance is 20% of Medicare pricing

Since drug plans are not part of Original Medicare, you would need to get a stand-alone drug plan. Premiums range from $7.30- $100 per month with copays for prescriptions.

We look at Original Medicare as starting point for your healthcare coverage. It opens the door to making choices, choices that can limit your deductibles and give you a wide range of coverage choices.

Next, we will look at one of those choices, Part C- Medicare Advantage plans.