Original Medicare is a federal program for hospitalization and medical care. It’s funded by payroll deductions at work, and by additional premiums. There are two parts, Part A and Part B. 

Part A covers in and outpatient hospital care. It expanded to cover; nursing facilities, nursing homes, hospice care, and hospital care at home.

Part B covers medical diagnosis and treatment, and detection to treat illness early. 

There are costs for Part A and Part B: Premiums, deductibles, copayments, and coinsurance. There’s no out-of-pocket limit on Part A or Part B costs.

1. Premiums: If you work long enough Part A is free. If not, it costs $278 or $506 monthly based on the Medicare taxes you paid. Part B’s premium is $164.90 and rises with income.

2. Penalties: At 65, you normally enroll in both Part A and Part B. Delaying either results in penalties.

3. Deductibles: Part A’s deductible is $1,600. A part deductible is $226.

4. Copays: Part A has a $400 per day copay for hospitalization and a $200 per day copay for skilled nursing.

5. Coinsurance: Part A has coinsurance of 20% for durable equipment Like wheelchairs and beds. Part B generally has a 20% coinsurance across the board.

Medigap or Medicare Supplement policies cover most of these.

a) They are private insurance paid for separately.

b) Cost is based on age and health.

c) Initially you can’t be declined, if you change policies, you can.

d) The key advantage is a national, deep, medical network.

There are ten standardized plans. The two best for coverage were dropped in 2020. Of the eight left, two are high deductible plans, two others don’t cover skilled nursing facilities, and one doesn’t cover 50% ($800) of the Part A’s deductible The remaining three have relatively comprehensive coverage and cover some international travel.