Original Medicare:
What It Does and Doesn’t Cover

Original Medicare includes two parts: A and B. The reason it’s called Original Medicare is because Parts A and B used to be the only Medicare coverage available until they added Part C (Medicare Advantage) and Part D (prescription drugs) later on.

BayCarePlus Part A Hospital

Medicare Part A helps pay for medically necessary care that requires a stay in the hospital or at a skilled nursing facility. It also covers hospice care for the terminally ill and some skilled home health care.

Medicare Part A is free if you or your spouse have paid into Social Security for 10 or more years. However, it does come with a deductible per hospital stay for each “benefit period.” This period begins when you’re admitted to the hospital and ends when you’ve been out of the hospital for 60 days in a row. After that, what you pay changes depending on the length of your stay.

Length of Hospital Stay You Pay
Days 1-60 $1,484 deductible ($484 per day in 2021) then nothing
Days 61-90 $371 per day ($371 per day 2021)
After 91 Days $742 per day ($742 in 2021)
(this will only be paid for once in your lifetime)
Beyond Lifetime Reserve Days All costs
No limit on out-of-pocket costs

Source: Medicare.gov.

These coverage amounts are for 2021 and may change from year to year.

BayCarePlus Part B Medical

Medicare Part B helps pay for medical care, including Doctor office visits, lab tests and screenings, and some skilled nursing care at home, as well as the Doctor services you receive when you are in the hospital.

Medicare Part B comes with a small deductible. You must also pay a monthly premium for Part B, which increases based on your income.

Medicare Pays You Pay
80% of medical care costs (once deductible is met) $203 Deductible
$148.50 monthly premium ($148.50 in 2021)*
Prescription Drug Coverage: Varies by Plan*
20% of all medical care (once deductible is met)
No limit on out-of-pocket costs

Source: Medicare.gov.

These coverage amounts are for 2021 and may change from year to year.

*Can vary based on income and potentially how long you’ve been enrolled in the Medicare program.

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