Original Medicare
The Foundation of Medicare. But Not the Full Picture
Original Medicare is made up of Part A and Part B, and it’s the starting point for most people when they enroll in Medicare. These two parts are managed by the federal government and help cover a wide range of healthcare services, but not everything. Understanding what’s included (and what isn’t) is key to making smart decisions about the rest of your coverage.
Part A - Hospital Insurance
Part A helps cover care you receive while admitted to a hospital or skilled nursing facility. It also includes hospice care and limited home health care. Most people don’t pay a premium for Part A if they or their spouse paid Medicare taxes while working.
What It Helps Cover:
Inpatient hospital stays
Skilled nursing facility care (after a qualifying hospital stay)
Hospice services
Limited home health care
While the coverage is broad, there are deductibles and coinsurance you’ll still be responsible for.
Part B - Medical Insurance
Part B helps cover outpatient care. Things like doctor visits, diagnostic testing, preventive screenings, and durable medical equipment. It comes with a monthly premium, which most people pay directly from their Social Security benefits.
What It Helps Cover:
Doctor Visits and outpatient care
Preventive services (screenings, vaccines, wellness visists)
Lab work and diagnostic tests
X-rays, MRIs, CT scans
Medical equipment like walkers or oxygen tanks
Once you meet the annual deductible, Medicare pays 80% of approved costs, and you’re responsible for the remaining 20%.
What Original Medicare Doesn't Cover
This is where many people get caught off guard. While Part A and Part B cover a lot, they don’t cover everything, and there’s no out-of-pocket maximum, which means your costs could keep adding up if you have frequent or serious medical needs.
What It Doesn't Cover:
Prescription drugs (You'll need a separate Part D plan)
Dental, vision, or hearing care
Long-term or custodial care (like nursing homes or assisted living)
Coverage while traveling outside the U.S.
Protection from high out-of-pocket costs
Because of these gaps, most people choose to add a Medicare Supplement plan (also called Medigap) or enroll in a Medicare Advantage plan (Part C). These options can help pay for what Original Medicare doesn’t, and give you more predictable, manageable healthcare costs.
Want To See How Medicare Advantage Works?
Follow Us!
Customer Care
Company
Legal
© 2026 The MacCalla Agency. All rights reserved. As a national Medicare brokerage, we work with multiple carriers to provide comprehensive plan options. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.