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Why Medicare Advantage
Plans Matter
Understanding Original
Medicare
Original Medicare is a federal fee-for-service health insurance program that consists of Part A (Hospital Insurance) and Part B (Medical Insurance). It helps cover essential healthcare services, such as:
- Inpatient hospital stays
- Doctor visits and diagnostic tests
- Preventive care and wellness services
- Outpatient medical treatments
- Prescription drugs, medical supplies, and equipment
- Laboratory tests, X-rays, and examinations
- Operating and recovery room services
- Diagnostic screenings
- Blood transfusions
- Durable medical equipment
Medicare Part A
Part B Overview
Original Medicare is made up of two main parts:
Part A (Hospital Insurance): Covers inpatient hospital care, skilled nursing facility care, hospice, and certain home health services.
Part B (Medical Insurance): Covers doctor visits, preventive care, outpatient services, and medical supplies.
Under Original Medicare, you typically pay for healthcare services as you receive them, including deductibles, coinsurance, and copayments.
These health benefits may be available to you!
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How it Work What is Obamacare insurance?
The ACA brings some uniformity to healthcare. Even though specific benefits may vary, core requirements are now the same for all qualified health plans. The law’s key provisions mandate they:
Be guaranteed issue— You can’t be denied coverage or charged more based on factors such as your health history and gender.
Include, at a minimum, these 10 essential health benefits:
Ambulatory patient services (outpatient hospital care)
Emergency services
Hospitalization
Pregnancy, maternity, and newborn care
Mental health and substance use disorder services
Prescription drug coverage
Rehabilitative and habilitation services and devices
Laboratory services
Preventive and wellness services and chronic disease management
Pediatric services, including oral and vision care
Cover specified preventive care at no additional cost— These “free” preventive services come in three categories (all adults, women, children) and include certain screenings, vaccinations, and condition-related counseling. You can’t be charged a copay or coinsurance for these preventive services, even if you haven’t met your plan’s deductible.
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