What Is Original Medicare?
Original Medicare is the traditional government-run program, consisting of two parts:
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Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice services, and limited home health care.
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Part B (Medical Insurance): Covers outpatient care, doctor visits, preventive services, lab tests, durable medical equipment, and some home health services.
Important Note:
Original Medicare doesn’t pay for everything. You’re responsible for deductibles, copayments, and coinsurance — and there’s no annual out-of-pocket maximum to limit your spending.
What Does Original Medicare Cover?
| Part | What It Covers | Your Costs |
|---|---|---|
| Part A | Hospital stays, skilled nursing, hospice, limited home health | Deductible, coinsurance after 60 days |
| Part B | Doctor visits, outpatient services, preventive care, lab work | Monthly premium, deductible, 20% coinsurance |
Key Points:
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Most people don’t pay a premium for Part A if they’ve worked and paid Medicare taxes for at least 10 years.
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Everyone pays a monthly premium for Part B, which may vary depending on income.
2025 Medicare Costs at a Glance
| Part | Coverage | Standard 2025 Costs |
|---|---|---|
| Part A | Hospital care, skilled nursing, hospice | $1,632 deductible per benefit period; $419/day for days 61–90; $838/day for lifetime reserve days |
| Part B | Outpatient care, preventive services | $185 monthly premium; $257 annual deductible; 20% coinsurance |
| Part C | Medicare Advantage (private plans) | Premiums vary by plan; network and copay rules apply |
| Part D | Prescription drug coverage | Premiums vary; higher earners may pay IRMAA surcharge |
Note: Medicare updates costs annually. Your actual expenses may vary based on income and location.
What Isn’t Covered by Original Medicare?
Original Medicare does not include:
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Prescription drugs (Part D plan required)
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Routine dental, vision, or hearing care
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Long-term custodial care
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Medical services received outside the U.S. (except in limited emergencies)
To fill these gaps, many beneficiaries opt for additional coverage.
Expanding Your Coverage: What to Do After Enrolling in Parts A & B
Once you’re enrolled in Original Medicare, you have two main paths to expand your coverage:
Option 1: Add a Medigap (Medicare Supplement) Plan
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Covers some or most out-of-pocket costs like deductibles and coinsurance
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Lets you see any doctor nationwide who accepts Medicare
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Does not include prescription drug coverage — you’ll need a separate Part D plan
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Requires additional monthly premium (on top of your Part B premium)
Think of Medigap as added protection that enhances the flexibility of Original Medicare.
Option 2: Choose a Medicare Advantage (Part C) Plan
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Combines Parts A and B — often includes Part D and extras like dental, vision, and hearing
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Offered by private insurance companies with defined provider networks (HMO or PPO)
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Includes an annual out-of-pocket spending cap
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May offer benefits like fitness programs and telehealth
Think of Medicare Advantage as a bundled, all-in-one private alternative with additional perks.
Comparing Your Medicare Options
| Feature | Original Medicare | Medicare Supplement (Medigap) | Medicare Advantage (Part C) |
|---|---|---|---|
| Core Coverage | Parts A & B (government) | Supplements Parts A & B | Replaces A & B with private plan |
| Doctor Choice | Any Medicare provider | Any Medicare provider | Network-based (varies by plan) |
| Drug Coverage | Requires Part D plan | Requires Part D plan | Often included |
| Out-of-Pocket Limits | No cap | No cap, but lowers costs | Annual maximum required |
| Extra Benefits | Limited | None beyond coverage gap help | Often includes dental, vision, hearing |
Make a Confident Medicare Choice
Choosing the right Medicare plan depends on your health needs, budget, and lifestyle. Whether you value the flexibility of Original Medicare with a Medigap plan or prefer the convenience of a Medicare Advantage plan, understanding your options is the first step.
At Bobby Brock Insurance, we specialize in helping you compare all available Medicare plans so you can make an informed, confident decision about your healthcare.
Ready to get started?
Book your one-on-one consultation today and let us guide you through your Medicare options.