ORIGINAL MEDICARE

Original Medicare is coverage managed by the federal government. Generally, there’s a cost for each service. Here are the general rules for how it works:

Can I get my health care from any doctor, other health care provider, or hospital?
In most cases, yes. You can go to any doctor, other health care provider, hospital, or other facility that’s enrolled in Medicare and is accepting new Medicare patients.

Are prescription drugs covered in Original Medicare?
With a few exceptions, most prescriptions aren’t covered in Original Medicare.
You can add drug coverage by joining a Medicare Prescription Drug Plan (Part D).

Do I need to choose a primary care doctor?
No, in Original Medicare you don’t need to choose a primary care doctor.

Do I have to get a referral to see a specialist?
In most cases, no. In Original Medicare, you don’t need a referral, but the specialist must be enrolled in Medicare.

Any questions, contact a licensed agent at (800) 983 – 8011

Should I get a supplemental policy?
You may already have employer or union coverage that may pay costs that Original Medicare doesn’t. If not, you may want to buy a Medicare Supplement Insurance (Medigap) policy.

What else do I need to know about Original Medicare?

• You generally pay a set amount for your health care (deductible) before Medicare pays its share. Then, Medicare pays its share, and you pay your share (coinsurance / copayment) for covered services and supplies. There’s no yearly limit for what you pay out-of-pocket.
• You usually pay a monthly premium for Part B.
You generally don’t need to file Medicare claims. The law requires providers (like doctors, hospitals, skilled nursing facilities, and home health agencies) and suppliers to file your claims for the covered services and supplies you get.