Welcome to our new Medicare Blog! We proudly serve clients in Winchester, VA, Martinsburg, WV, and Charles Town, WV. The purpose of this page is to educate our community about Medicare and outline different ways to obtain coverage. To begin, let’s look at the basics—today’s focus is ORIGINAL MEDICARE.
Understanding Original Medicare
Are you turning 65 soon and wondering about your health coverage options? Maybe you’re already receiving piles of letters that leave you confused. Fortunately, Original Medicare, managed by the federal government, gives you access to hospitals, doctors, and healthcare providers that accept Medicare.
Who Qualifies?
Original Medicare provides health insurance for:
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People age 65 and older
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People under 65 with certain disabilities who received Social Security disability benefits for 24 months
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People of any age with end-stage renal disease
The Two Parts of Original Medicare
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Medicare Part A: Hospital coverage
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Medicare Part B: Outpatient medical services, such as doctor visits
You can sign up for Part A and/or Part B during your Initial Election Period. This seven-month window starts three months before your Part B effective date, includes the month of, and ends three months after. For most people, the effective date is the month of their 65th birthday.
What Does It Cost?
Most people qualify for premium-free Part A if they or a spouse worked and paid Medicare taxes for at least 10 years (40 quarters). Part B, however, always has a premium. The amount depends on your income, but most people pay the standard rate—$174.70 in 2024 and $185 in 2025.
Key Features of Original Medicare
One major benefit is flexibility. Original Medicare has no networks, meaning you can see any doctor, specialist, hospital, or healthcare facility nationwide, as long as they accept Medicare patients. That’s great news!
On the other hand, there is no maximum out-of-pocket limit. Medical bills can add up quickly and create serious financial strain. Not so good.
Finally, while Medicare Part B may cover certain outpatient prescription drugs administered in a healthcare setting, Original Medicare generally does not cover prescriptions. Therefore, you’ll need to purchase a separate drug plan (Part D) from a private insurance company.
Need Help?
We can help you select the right insurance plan based on your needs. Call us today at 540-662-4432 to speak with Brian or one of our agents, or visit Medicaretrustedagents.com for more information.
