Overview

Original Medicare is comprised of Part A and Part B. Think of Medicare Part A (hospital insurance) and Part B (medical insurance) benefits as your foundational coverage. If you choose to replace this coverage with a Medicare Advantage plan, you are guaranteed to receive at least the same level of benefits as you'd get with Original Medicare. Medicare Supplement insurance (Medigap) can fill in some of the gaps in Original Medicare coverage.

    Benefit Period

    is the way the Original Medicare program measures your use of inpatient hospital and skilled nursing facility (SNF) services. It begins the day that you enter a hospital or SNF and ends when you have not received inpatient hospital or Medicare-covered skilled care in a SNF for 60 days in a row.
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  • How much is the Medicare Part A premium?

    Short Answer:

    Most people are eligible for premium-free Medicare Part A (hospital insurance). As long as you have earned 40 Social Security credits, equivalent to 10 years of work, you won't have to pay a premium for Part A. 

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    Additionally, if your spouse or ex-spouse has earned 40 Social Security credits, you're eligible for premium-free Part A.

    Because you can earn up to four credits per year, they are also often referred to as quarters.

    If you do need to buy Part A in 2018, the price depends on the number of quarters you have paid Medicare taxes:

    • Between 30 and 39 quarters: $232 per month
    • Less than 30 quarters: $422 per month

    To see how many quarters you have earned, check with Social Security here.

  • How much is the Medicare Part B premium?

    Short Answer:

    The standard Medicare Part B (medical insurance) premium in 2018 is $134 per month. However, you may pay more or less than this amount depending on your income and other factors.

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    People who receive Social Security benefits will pay slightly less, around $130 on average. If you don’t receive Social Security and your income is over a certain amount, you’ll pay more.

    You can find out your premium amount from the table below:

  • What is not covered by Medicare Part A?

    Short Answer:

    Original Medicare doesn’t cover all of your healthcare needs. Generally, Medicare Part A (hospital insurance) doesn’t cover long-term care (also called custodial care), private nursing, healthcare you receive outside of the U.S., hospital stays that aren’t “medically necessary” (for example, for cosmetic surgery), and prescription drugs, unless you receive them while you’re in the hospital as part of your treatment.

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    There may be other services not covered by Part A. You can find out if Medicare covers a test, item, or service here.

  • What is not covered by Medicare Part B?

    Short Answer:

    Original Medicare doesn’t cover all of your healthcare needs. Generally, Part B (medical insurance) won’t cover prescription drugs (with some exceptions), routine foot care, dental, vision, hearing care, hearing aids, dentures, and acupuncture.

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    There may be other services not covered by Part B. You can find out if Medicare covers a test, item, or service here.

  • Does Medicare Part B cover dental?

    Short Answer:

    Unfortunately, regular visits to the dentist aren’t covered under Medicare Part B (medical insurance). When you need cleanings, fillings, dentures, and other dental work, you’ll either have to pay out of pocket or get supplemental insurance.

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    Part B only covers “medically necessary” care. That does not include dental services.

    However, you have plenty of other options for dental coverage. Among them:

    You can buy a stand-alone dental plan. See some options here.

    Many Medicare Advantage plans (Part C) include dental benefits.

    There are also a variety of providers you can turn to for dental work if you can’t afford or don’t want to pay for supplemental insurance or Medicare Advantage. These include community health centers, reduced-cost clinics, and even local dental schools.

    One important caveat: Emergency dental care is covered under Medicare Part A (hospital insurance). So while you’re on your own when it comes to basic dental services, if you have to go to the hospital for something dental-related—such as an infection or surgery on your jaw—then Medicare has you covered.

  • Does Medicare Part B cover vision?

    Short Answer:

    No, Medicare Part B (medical insurance) does not cover vision care and services. Part B only covers services that are considered "medically necessary," and routine vision coverage does not qualify.

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    There are a few exceptions:

    • Diabetes. If you have diabetes, Medicare will cover one eye exam per year.
    • Glaucoma. Medicare will pay for one glaucoma test a year for people who are at high risk for the disease.
    • Macular degeneration. Medicare will cover certain tests and treatments for people with age-related macular degeneration.

    These services are covered up to 80% of the Medicare-approved amount by Part B. You are responsible for paying the remaining 20%.

    Finally, while Medicare Part B and Medicare Supplement (Medigap) plans do not cover routine eye care, there are some Medicare Advantage (Part C) plans that do. Many insurance companies also offer stand-alone vision plans that cover eye exams, glasses and contact lenses, and more.