The Traditional Medicare Program
Original Medicare is the fee-for-service health insurance program run directly by the federal government. It's made up of two parts — Part A and Part B — and it's the foundation that every other Medicare option (Medigap, Medicare Advantage, and Part D) builds on or replaces.
The Two Parts
What Each Part Covers
Part A: Hospital Insurance
✓ Inpatient hospital stays
✓ Skilled nursing facility care (after a qualifying hospital stay)
✓ Home health care
✓ Hospice care
Most people don't pay a monthly premium for Part A because they (or a spouse) paid Medicare taxes while working.
Part B: Medical Insurance
✓ Doctor visits and specialist care
✓ Outpatient care and observation services
✓ Preventive services (screenings, vaccines, annual wellness visit)
✓ Durable medical equipment (wheelchairs, walkers, oxygen equipment)
Part B carries a standard monthly premium, set each year by Medicare, plus an annual deductible.
How It Works
What to Expect With Original Medicare
Nationwide Access
You can see any doctor or hospital in the country that accepts Medicare — no networks to worry about.
No Referrals Needed
You can go straight to a specialist without a referral from a primary care doctor.
Standard 80/20 Split
After you meet the Part B deductible, Medicare typically pays 80% of the approved cost for covered services, and you pay the remaining 20% as coinsurance.
No Out-of-Pocket Limit
Original Medicare has no annual cap on what you could pay in coinsurance. This is the main reason many people pair it with a Medicare Supplement (Medigap) plan.
Worth Knowing
What Original Medicare Doesn't Cover
Original Medicare generally does not cover routine dental, vision, or hearing care, and it does not include prescription drug coverage on its own. Because of this, most people on Original Medicare add a separate Part D plan for medications, and many also add a Medicare Supplement (Medigap) plan to help with the 20% coinsurance and lack of an out-of-pocket cap.