Medicare is a health insurance program operated by the Federal Government and is part of the Social Security Act. Most US residents who are 65 or older are eligible, along with certain younger people with disabilities, people with End-Stage Renal Disease and people with ALS.
“Original Medicare” consists of two different ‘Parts,’ which cover specific services:
Medicare Part A covers certain inpatient hospital stays, skilled nursing facility care, hospice, and home health care in certain situations.
Medicare Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
“Gaps” in Original Medicare
Parts A and B cover most care and pay a large portion of your costs, but not all. When there is a cost to you under Original Medicare, it is referred to as a “Gap.”
Original Medicare does NOT have an annual “Out of Pocket Limit.”
What else isn’t covered by Part A & Part B?
In addition to the “Gaps,” Original Medicare doesn’t cover everything. Some of the items and services that Original Medicare doesn’t cover include:
- Long-term care (also called custodial care)
- First 3 pints of blood
- Most dental care
- Eye examinations related to prescribing glasses
- Glasses and contacts in most cases
- Cosmetic surgery
- Health club membership
- Foreign travel emergency in most cases
- Hearing aids and exams for fitting them
- Routine foot care