Original Medicare doesn't cover all the cost.

Most Americans look to the Original Medicare program for their health insurance needs when they turn 65 or become disabled. Original Medicare only covers about 80% of your medical and hospital expenses. You are responsible to pay the other 20% of your medical and hospital costs — and 100% of your prescription costs.

 

What is Original Medicare?

Medicare is federal health insurance offered primarily to people age 65 and older and disabled individuals under the age of 65. Created in 1965, Medicare started with just two parts—Part A and Part B. Later on, additional parts—Part C and Part D—were added as the needs of Medicare beneficiaries changed.

It's important to understand that Original Medicare (Part A and Part B) does not cover all of your medical expenses. Learn about other options that are available and why they may be right for you.

 

Part A

Hospital insurance for inpatient stays and more:

  • Usually there is no monthly premium for Part A coverage.
  • You pay a Part A deductible and coinsurance, which are out-of-pocket expenses, when you receive care. You are responsible for paying these expenses unless you have a separate health insurance plan to cover them.
     

Part B

Medicare insurance for doctor services and more:

  • Part B is optional coverage
  • You usually pay a Monthly Part B premium
  • For most services, you pay a calendar year Part B deductible and coinsurance unless you have insurance for those expenses
     

Part D

Medicare-approved prescription drug coverage:

  • Part D is sold only through private organizations, like insurers, that are contracted with Medicare.
  • Coverage can be purchased either as a "stand-alone" prescription drug plan (PDP) or may be included with a Part C Medicare Advantage plan. Plans that combine medical coverage and prescription drug coverage are called Medicare Advantage Prescription Drug (MA-PD) plans.
     

Part C

Medicare Advantage:

  • Part C Medicare Advantage (MA) plans replace Original Medicare with coverage offered by private organizations, like insurers, that are contracted with Medicare.
  • These plans offer everything covered by Original Medicare Part A and Part B, plus they often include prescription drug coverage and coverage of certain services not paid by Original Medicare.
  • Premiums and deductibles vary by plan.