- 原始的医疗保险包括医疗保险部分和标准t B。
- It’s available to most people age 65 and older and to some younger people with certain health conditions and disabilities。
- Part A covers inpatient hospital services, and the monthly premium is free for most people。
- Part B covers medically necessary outpatient and preventive care, but there are are monthly premium costs.
- Any gaps in coverage from original Medicare can be filled by additional parts or plans that are available to buy。
Original Medicare is a federal program that provides healthcare for Americans age 65 and older. It also provides coverage for some people with specific conditions and disabilities, regardless of age.
Original Medicare has two parts, Part A and Part B. Read on to learn what these parts cover, their costs, how to enroll, and more.
Medicare has multiple parts: Part A, Part B, Part C, and Part D. There is also Medigap, which is made up of 12 plans that you can choose from.
Original Medicare only has two parts: Part A and Part B.
Medicare was founded in 1965 as a public health insurance program for older adults. It is managed by the Centers for Medicare & Medicaid Services (CMS).
Themain source of fundingfor Medicare Part A is payroll taxes and taxes on Social Security income. That’s whyMedicare A部分是free for most people who have worked, or whose spouses have worked, for at least 10 years.
B部分和D部分主要由公司，收入和消费税以及受益人支付的每月保费支付。Medicare部分bandMedicare部分dare voluntary programs and are not free from monthly costs.
Medicare A部分coverage
Medicare A部分封面住院医院服务，例如：
- semiprivate rooms
- meals
- 护理
- medications, services, and supplies you need as an inpatient
- inpatient care if you participate in certain clinical research studies
Part A covers inpatient services at these types of facilities:
- 急性护理医院
- critical access hospital
- long-term care hospital
- limited stays at askilled nursing facility
- inpatient rehabilitationhospital
- psychiatric hospital (inpatient mental health care has a 190-day lifetime cap)
- limited家庭医疗保健
- 临终关怀
Medicare B部分覆盖范围
Medicare部分bcoversmedically necessary services such as doctor visits and preventive care. It also covers ambulance services, durable medical equipment, and outpatient mental health services.
Part B covers 80 percent of the Medicare-approved costs of services you receive as an outpatient. It also covers some services you might need in a hospital.
Medicare B部分涵盖的一些特定示例包括：
- medically necessary care provided by your general practitioner or a specialist
- doctor visits you have as an inpatient within a hospital setting
- outpatient hospital care, such as急诊室处理
- 紧急救护车运输
- preventive care, such asmammogramsand other types of cancer screenings
- most vaccines, including flu shots andpneumonia shots
- smoking cessation programs
- 实验室测试，blood tests, andX射线
- durable medical equipment
- mental health services
- 一些chiropractic services
- intravenous medications
- clinical research
Medicare Part C coverage
Medicare C部分（Medicare Advantage）保险是可选的,可以介绍吗re beneficiaries who have parts A and B. Part C plans legally must cover at least as much as original Medicare, as well as extras like想象,dental, and处方药。
Medicare部分dcoverage
Medicare部分dcovers prescription medications. It is voluntary but beneficiaries are strongly urged to get some type of prescription drug coverage. If you decide you want a Medicare Advantage Part C plan, you do not need Part D.
Medigap覆盖范围
Medigap（Medicare补充保险）旨在为原始Medicare的某些差距支付费用。它实际上不是医疗保险的一部分。相反，它由您可以选择的10个计划组成（请注意，一个计划F计划有两个版本）。这些计划在可用性，成本和承保范围方面有所不同。
原始Medicare的两个部分旨在涵盖医院所需的服务和门诊。您可能会认为这两个类别涵盖了每项可以想象的服务，但它们却没有。因此，检查您需要的服务或用品是否由Medicare涵盖，这总是很重要的。
Some of the things original Medicaredoes notcover include:
- 针刺
- 大多数处方药
- 想象care
- 牙齿保健
- 保管（长期）护理，例如nursing homes
- services or supplies that are not considered medically necessary
Although original Medicare doesn’t cover the services listed above, many Medicare Advantage plans do. If any of these benefits are important to you, you cansearch for Medicare Advantage plans在您提供所需覆盖范围的您所在地区。
Medicare A部分costs
Most people who are eligible for Medicare are also eligible for premium-free Part A. You will most likely beeligible for premium-free Part A如果：
- 您有资格获得社会保障退休福利
- you are eligible for Railroad Retirement Board benefits
- you or your spouse had Medicare-covered government employment
- you are younger than age 65 but have received Social Security or Railroad Retirement Board disability benefits for at least 2 years
- you haveend stage renal disease (ESRD)or肌流侧硬化症（ALS）
如果您不符合A Prem-Fream-farmy A部分的资格，则可以购买。
Part A monthly premiums范围$274 to $4992022年，根据您或您的配偶支付的医疗保险税工作时候。
通常，购买A部分的人也必须为B部分购买和支付每月的保费。
Medicare B部分费用
In 2022, there is an annualdeductible for Medicare Part Bof$233。The monthly premium typically costs$170.10，这是大多数人付款的费用。
However, if your income is above a certain amount, you may also pay anincome-related monthly adjustment amount (IRMAA)。Medicare着眼于您2年前报告的税收总收入。如果您的年收入超过$ 91,000as an individual, your monthly premium may include an IRMAA. Married people with combined incomes over$182,000also pay higher monthly premiums.
The Social Security Administration will send you an IRMAA letter in the mail if it is determined you need to pay a higher premium.
Original Medicare costs at a glance
| Part A | Part B | |
|---|---|---|
| Monthly premium | 大多数人免费（274美元或$ 499的人） | $170.10 |
| Deductible | $1,556 per benefit period | $233 per year |
| Coinsurance | $389 per day for stay of 61–90 days; $778 per day for stays longer than 90 days | 20% of Medicare-approved cost for items and services |
How much do Part C, Part D, and Medigap cost?
Medicare Part C, Part D, and Medigap all have varying costs based on your county, ZIP code, and the plan provider you choose.
这些计划是通过私人保险公司购买的，但必须遵循联邦准则。因此，有相关费用的上限，例如您的自付费用，自付额和每月保费。
例如，对于Medicare C部分，您的网络内提供商的最大自付费用是$7,550。If you use both in-network and out-of-network providers, your maximum out-of-pocket annual limit is $10,000.
Many Part C plans have a $0 premium. Others can go as high as $200 a month, or more, which is in addition to your monthlyB Part Premium。
The national base beneficiarypremium for Medicare Part D是$33.37in 2022. However, this cost can be higher based on your income. Some Part D plans also have a $0 deductible.
Medicare requires you to use Medicare-approved providers and suppliers when you seek medical care. Most doctors in the United States accept Medicare, but there are exceptions. It’s always important to ask if your doctor takes Medicare when you make an appointment.
To be eligible for original Medicare, you must be a U.S. citizen or a permanent U.S. resident who has lived here lawfully for at least 5 consecutive years.
Most people are eligible for Medicare when they are age 65 or older. However, there are exceptions. Some people who are under age 65 are eligible if they or their spouse have received disability benefits from Social Security or Railroad Retirement Board for at least 24 months.
You can enroll for Medicare online through theSocial Security Administration website。You can also enroll by calling Social Security at 800-772-1213 (TTY: 800-325-0778).
If you prefer to enroll in person, you can do so at your local Social Security office. Call first to see if an appointment is required.
您还可以在线研究Medicare C部分和D部分以及Medigap计划。
什么是特殊的入学期？
You may be able to apply late for original Medicare if you waited to sign up because you were employed and had health insurance. This is referred to as the special enrollment period.
公司的规模将确定您有资格进行特殊入学率。如果您有资格，则可以在当前覆盖范围结束后的8个月内或在覆盖范围结束后的63天内申请原始Medicare。
Part D plans can be changed during special enrollment periods if:
- you moved to a location not served by your current plan
- your current plan has changed and no longer covers your county or ZIP code area
- 您搬进或出国养老院
Determining your current and anticipated medical needs can help you create a roadmap to help you choose coverage. Consider the following issues as you decide:
- Prescription drugs.即使Medicare D部分是自愿的，也必须考虑您的处方药需求。从长远来看，请注册D部分或包括药物在内的优势计划，可以节省您的钱。
- Vision and dental needs.因为这些不是covered by original Medicare, it may make sense for you to buy a plan that provides this coverage.
- Budget.在退休后计划您预期的每月和年度预算。一些计划的每月保费较低，这使其具有吸引力。但是，这些计划通常会有更高的销售。如果您在平均一个月内有很多医生的约会，请在购买前加上$ 0的高级计划的销售额。
- Chronic conditions.Keep in mind any known chronic condition or one that runs in your family, as well as upcoming procedures you know will be needed. If you are comfortable using in-network doctors, going with a Medicare Advantage plan might make the most sense for you.
- Travel.If you travel extensively, opting for original Medicare plus Medigap may be a good option. Many Medigap plans pay for a large portion of emergency medical services you may need when traveling outside the United States.
Original Medicare is a federal program that is designed to provide healthcare for Americans age 65 years and older and for those with certain disabilities who are under age 65.
Many people might assume that Medicare is free, but unfortunately, that is not the case. However, there are affordable options within Medicare that can fit into most budgets.