Original Medicare (Part A and B)

man and woman walking outside

Medicare Parts A and B (Original Medicare) are managed by the federal government.

Some individuals who receive Social Security benefits are automatically enrolled in Original Medicare while others need to apply for it as they approach their 65th birthday.

Find the Best Medicare Plan for You

For more than 90 years, Blue Cross and Blue Shield companies have been putting members first, which is why most doctors trust us for Medicare coverage. Explore what Blue Cross and Blue Shield companies have to offer by entering your ZIP Code to find Medicare coverage that fits your needs.

  • If you receive insurance through an employer, please enter the ZIP Code. If you need further help identifying your BCBS company, please contact the employer who provides your insurance for assistance.
  • If you do not receive your insurance though an employer, please enter the ZIP Code for where you live.

Some employers offer BCBS Medicare coverage to their eligible retirees. To find out if you are eligible, reach out to your company benefits representative.

Select BCBS Provider

    Federal employees, retirees and their families are insured by the Federal Employees Program (FEP).
    Federal Employee Program

    Medicare Part A

    Medicare Part A covers inpatient care provided in hospitals or skilled nursing facilities, home health care and hospice care for the terminally ill.

    Part A costs include:
    Premium

    There is no insurance premium for Part A if you or your spouse contributed to Social Security for at least 10 years. Otherwise, an option to buy Medicare Part A is available.

    Deductible

    You must first meet a Part A deductible before Part A helps with your covered medical expenses, similar to how Medicare Part B works.

    Copays

    A copayment or cost sharing may apply to specific services, such as extended stays in a hospital or skilled nursing facility.

    Coinsurance

    Part A has coinsurance for:

    • Inpatient hospital care lasting between 61 and 90 days total per benefit period.
    • Inpatient mental health care lasting between 61 and 90 days total per benefit period.
    • Skilled nursing care lasting between 21 and 100 days total per benefit period.
    • Coinsurance is also available for a limited number of additional days.
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    Part A - Limits and Considerations

    Limits

    The following coverage restrictions apply to Medicare Part A:

    • Inpatient hospital care is limited to 90 days total per benefit period.
    • Inpatient mental health care is limited to 90 days total per benefit period.
    • Skilled nursing care is limited to 100 days total per benefit period.
    • For each type of care, you can receive coverage for 60 additional days throughout your lifetime. These are known as "lifetime reserve days."

    Things to Consider

    • Coverage can be used anywhere in the United States.
    • Most hospitals in the U.S. participate in Medicare.

    Medicare Part B

    Medicare Part B covers doctor visits, durable medical equipment, speech therapy, occupational therapy, physical therapy, and other outpatient services. 

    Part B costs include: 
    Premium

    Medicare Part B has a monthly insurance premium that is based on when you enroll and your annual household income. This premium is commonly paid through Social Security withholdings. It is separate from the health insurance premiums you will pay if you choose Medigap, Medicare Advantage (Part C) or Prescription Drug Coverage (Part D).

    Deductible

    You must first meet an insurance deductible before Part B helps with your medical costs.

    CoPay

    A copayment or cost sharing may apply to specific services, such as those received in an outpatient hospital setting.

    Coinsurance

    You pay 20%for some medical services, such as doctor services, outpatient therapy and durable medical equipment. 

    Preventative Care

    No deductibles, copays or coinsurance are required for Medicare-covered preventive care services, such as annual wellness visits and mammograms for women.

    Part B - Limits and Considerations

    Limits

    Under Medicare Part B, there are annual limits on services for physical therapy, occupational therapy and speech language pathology.

    Things to Consider

    • Part B coverage can be used anywhere in the United States if you have Original Medicare and the physician accepts Medicare.
    • You can select any doctor in the United States who accepts Medicare patients.
    • Part B premiums, standard deductibles and cost sharing amounts generally change annually on January 1st.

    Medicare Eligibility

    Unsure if you’re eligible? Let us help you figure out where you stand. You are generally entitled to Medicare if you meet any of the following criteria:

    • You are aged 65 or above.
    • You are disabled and have received disability benefits from Social Security or Railroad Retirement Board (RRB) benefits.
    • You have been diagnosed with end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS, “Lou Gehrig’s disease”).

    Understanding Eligibility

    Learn more about Medicare enrollment and eligibility.

    Find the Best Medicare Plan for You

    For more than 90 years, Blue Cross and Blue Shield companies have been putting members first, which is why most doctors trust us for Medicare coverage. Explore what Blue Cross and Blue Shield companies have to offer by entering your ZIP Code to find Medicare coverage that fits your needs.

    • If you receive insurance through an employer, please enter the ZIP Code. If you need further help identifying your BCBS company, please contact the employer who provides your insurance for assistance.
    • If you do not receive your insurance though an employer, please enter the ZIP Code for where you live.

    Some employers offer BCBS Medicare coverage to their eligible retirees. To find out if you are eligible, reach out to your company benefits representative.

    Select BCBS Provider

      Federal employees, retirees and their families are insured by the Federal Employees Program (FEP).
      Federal Employee Program

      Medicare overview information on this website was developed by the Blue Cross and Blue Shield Association to help consumers understand certain aspects about Medicare. Viewing this Medicare overview does not require you to enroll in any Blue Cross Blue Shield plans. Plans are insured and offered through separate Blue Cross and Blue Shield companies. Medicare Advantage and Prescription Drug Plans are offered by a Medicare Advantage organization and/or Part D plan sponsor with a Medicare contract. Enrollment in these plans depends on the plan’s contract renewal with Medicare. To find out about premiums and terms for these and other insurance options, how to apply for coverage, and for much more information, reach out to your local BCBS company. Each Blue Cross and Blue Shield company is responsible for the information it provides. For more information about Medicare, including a complete list of plans available in your area, please contact the Medicare program at 1.800.MEDICARE (TTY users should call 1.877.486.2048) or visit www.medicare.gov.

      Medicare has neither reviewed nor endorsed this information.