What is Original Medicare?
TL:DR (AKA Too Long, Didn’t Read. As the kids say!)
Consists of two “Parts” Part A & Part B
Part A is hospital insurance
Part B is medical insurance
People like to make this more complex than it really needs to be. Original Medicare is made up of two “Parts” Part A and Part B. Part A is your hospital insurance, think room and board. Part B on the other hand, covers medical insurance: doctors visits, outpatient services, etc… Your Medicare card (red, white, and blue card) has your MBI (Medicare Beneficiary Identifier) your Part A & Part B effective date on it. It’s worth noting that the old school Medicare cards had your social security number as your identification number.
In essence, that’s it. You now understand Original Medicare. It has two parts and is the gateway into an Advantage plan or Supplement/Medigap. You can literally stop reading here, unless you’d like a deeper dive.
Part A is a $0 premium, for almost everyone, however there can be a premium tied to it, but not common. If you or your spouse worked for 10 years (or 40 quarters), it’s $0 due to you paying into the Medicare tax.. Without the work history there is a cost.
When you hear people say they pay 100’s for their Medicare, most often they’re referring to their Part B premium, which is normally taken out of Social Security deposits (more on that later).. Part B premium is based on IRMAA (Income-Related Monthly Adjustment Amount). They look at your two year prior tax returns and go off IRMAA. In 2026, it’ll be your 2024 taxes. The minimum for Part B in 2026 is $202.90.
But Ryan, I don’t take social security! They’ll still getcha!
You will then be billed for your Part B premium (it defaults to quarterly, but you can get it switched to monthly by calling SS). Once you opt for SS benefits, that amount will be taken out of your check, monthly, pre tax.
Once you have an understanding of Original Medicare, you can now move to grasping the copays, coinsurance, deductibles, I don’t think anyone ever uses the correct terminology (but that’s what we’re here for!) costs. Original Medicare covers 80% a year, meaning you are on the hook for the remaining 20% for the entire year. If your bill is 100 grand, you owe twenty thousand of that. If your next bill in the same year is ten thousand dollars, you still owe your share AKA two thousand dollars. This is very important to know and understand - I always joke that A + B = US. You NEED Original Medicare (Both A & B, that’s an important point) to get a Medicare Advantage or Supplement/Medigap. If you have only Part A, you do not have Original Medicare. You need both parts.
