Original Medicare

Original Medicare is the traditional, government-run Medicare program that has been available since 1966. It includes Part A (hospital insurance) and Part B (medical insurance) and is administered directly by the federal government, as opposed to Medicare Advantage (Part C), which is delivered through private insurance companies.

With Original Medicare, you can see any doctor or hospital in the country that accepts Medicare, with no network restrictions and no referrals needed. Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. Part B covers doctor visits, outpatient services, preventive care, durable medical equipment, and many other medical services.

Original Medicare typically covers about 80% of approved costs after you meet the deductible, and you pay the remaining 20% coinsurance with no annual out-of-pocket maximum. This is a significant gap; a major surgery could leave you owing tens of thousands of dollars. That's why many people on Original Medicare also buy a Medigap policy (Medicare Supplement Insurance) to help cover what Medicare doesn't pay.

Original Medicare also doesn't include prescription drug coverage. You'll need a separate Part D plan to cover medications, or you'll pay full price at the pharmacy.

People often compare Original Medicare to Medicare Advantage when deciding which path to take. Original Medicare offers maximum provider flexibility; Medicare Advantage typically has lower out-of-pocket costs and includes drug coverage but requires you to use a network. Your best choice depends on your health needs, preferred doctors, and budget.