Original Medicare Part A & B
Original Medicare (sometimes called Traditional Medicare) is administered directly by the federal government and comes in two parts. If you have Original Medicare, you can enroll in other parts for additional coverage.
Hospital Insurance (Part A)
Medicare Part A is also known as hospital insurance because it primarily covers hospital care and other critical needs. In general, Medicare Part A covers:
- Inpatient care in a hospital
- Skilled nursing facility
- Nursing home care (inpatient care in a skilled nursing facility that’s not custodial or long-term care)
- Hospice care
- Home health care
You are eligible for Part A if you or your spouse paid into Social Security for at least 10 years through your employment and if you are a citizen or permanent resident of the United States.
Most people can get Part A premium-free ($0) because they or their spouse paid Medicare taxes while working. However, it’s important to keep in mind that Part A services can carry a substantial deductible, copayments, or coinsurance, which can drive up your out-of-pocket costs.
In 2023, the deductible for Part A is $1,600 per benefit period. The benefit period begins the day you enter the hospital or facility and ends after you have not needed inpatient care for 60 days in a row.
Medical Insurance Coverage (Part B)
Medicare Part B is also known as medical insurance because it covers ongoing medical needs including doctor appointments, laboratory tests, and X-rays. Medicare Part B covers:
- Doctors’ and other health care providers’ services
- Outpatient care
- Ambulance services
- Durable medical equipment
- Some preventive services
- Home health care
- Certain prescription drugs
You are eligible for Part B if you reside in the United States (except residents of Puerto Rico) and are eligible for Part A.
In 2023, the standard Part B premium is $164.90/month. Most people will pay this amount, but if the modified adjusted gross income reported on your IRS tax return two years before enrollment is above a certain amount, you may pay an additional charge. Part B also has an annual deductible ($226 in 2023) and other copayments and coinsurance (typically 20%) that may apply.
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Excellus BlueCross BlueShield is an HMO plan and PPO plan with a Medicare contract. Enrollment in Excellus BlueCross BlueShield depends on contract renewal. Submit a complaint about your Medicare plan at www.Medicare.gov or learn about filing a complaint by contacting the Medicare Ombudsman. Y0028_8830_C.
This page last updated 02-14-2023.