V. Reed Speas II - Medicare Insurance Agent FL
Office Phone : (239) 288 - 0880 Website Link: www.Medicare-Deductible-F-Agent.comPersonal Email: V.Reed.Speas@gmail.com

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Medicare part A and B - Original Medicare

What is Original Medicare?

Original Medicare is the traditional fee-for-service program offered directly through the federal government. Under Original Medicare, the government pays directly for the health care services you receive. You can see any doctor that takes Medicare (and most do) anywhere in the country. Original Medicare is sometimes called “traditional” Medicare. When Traditional Medicare has the the support of a Medicare Supplemental Insurance Plan F a person can never see a medical bill for a Medicare covered service. If only all insurance products protected their clients that well.

Traditional Medicare is a health insurance program available to:

• People 65 or older
• People under 65 with certain disabilities
• People of any age with End-Stage Renal Disease (ESRD)

Medicare part A: Hospital Insurance

- Most people don't pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working. Medicare Part A (Hospital Insurance) helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits.

Medicare Part B: Medical Insurance

Most people pay a monthly premium for Part B. Medicare Part B (Medical Insurance) helps cover doctors' services and outpatient care. It also covers some other medical services that Part A doesn't cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary.

What You Will Have to Pay with Medicare

For Medicare parts A and B, you generally must pay monthly premiums, as well as deductibles, copayments, and coinsurance. You also pay the full cost of services not covered by Medicare.

  • Premiums are amounts you pay regularly to keep your coverage. Most people do not have to pay a Part A premium (this amount was paid via social securiity tax previous in life), but everyone must pay the Part B premium. The premium amounts may change each year in January.

  • A deductible is the amount you must pay for covered medical expenses before Medicare begins to pay.

  • A copayment is a fixed charge for a medical service.

  • Coinsurance is the percentage of the cost of a covered service that you pay after Medicare pays its portion of the cost.

Health care providers who have accepted “assignment” have agreed to limit their fee to the Medicare-approved amount for a service or supply, although you must still pay any deductibles, coinsurance, and copayments due.

Providers who do not accept Part B assignment may charge as much as 15 percent more than the Medicare-approved amount. You must pay the Medicare excess charge. The amount you owe is shown on the Medicare Summary Notice that you receive each quarter. If you were charged more than the 15 percent and paid it, your provider must refund the excess charges to you within 30 days.

If you believe a provider has overcharged you use your summary notice to verify charges. Then contact the carrier or supplier whose contact information is shown in the summary notice.

Medicare maintains a directory of providers and suppliers that work with Medicare. The directory lists physicians and other providers who accept assignment on Medicare claims.

Click the following link to read more at our Medicare Insurance Question and Answer blog

**The information on this website is intended for informational purposes only and may change at any time.   Medicare Supplement Advisor and V. Reed Speas himself are not connected with or endorsed by the U.S. government or the federal Medicare program.