Part A
Hospital insurance
Helps cover inpatient hospital care, limited skilled nursing care, hospice, and certain home health services when Medicare requirements are met.
Medicare coverage explained
Original Medicare: Parts A and B
Part A and Part B form the foundation of Original Medicare. We will help you understand what each part covers and what decisions may come next.
Start with the foundation
How Parts A and B work together
Original Medicare divides hospital and medical coverage into two parts.
Part A helps cover inpatient hospital care and certain related services. Part B helps cover doctor visits, outpatient care, preventive services, and certain medical equipment.
Together, Parts A and B cover many healthcare needs, but they do not cover everything. You may still have deductibles, coinsurance, and other costs to consider.
Two parts, different roles
Part A covers hospital care. Part B covers medical care.
Most people use both parts to build their Original Medicare coverage.
Part B
Medical insurance
Helps cover doctor visits, outpatient care, preventive services, and certain medically necessary equipment and supplies.
Part A coverage
What Part A generally covers
Part A focuses on inpatient and facility based care. Medicare rules and medical necessity determine whether a specific service is covered.
Commonly covered
- Inpatient hospital care
- Limited skilled nursing facility care after a qualifying stay
- Hospice care for people who meet Medicare requirements
- Certain home health services
Common limitations
- Private duty nursing
- A private hospital room unless medically necessary
- Personal items and convenience services
- Long term custodial care
Coverage rules and your share of costs can vary by service and may change each year.
Part A basics
Costs and eligibility at a glance
Your work history and personal circumstances help determine your Part A costs and enrollment path.
Monthly premium
Many people qualify without a Part A premium
Your work history, or the work history of a spouse, may help you qualify. People without enough work credits may be able to purchase Part A.
Your share of costs
Other costs still apply
Part A can include a deductible, coinsurance, and other costs. Some costs are based on benefit periods rather than a calendar year.
Eligibility
Most people qualify at age 65
Some people qualify earlier because of a disability, ALS, or permanent kidney failure requiring dialysis or a transplant.
Part A enrollment
Know when and how to enroll
Your next step depends on whether Medicare will enroll you automatically and whether you have current employer coverage.
- 1
Check your enrollment status
Some people are enrolled automatically through Social Security or the Railroad Retirement Board. Others need to apply.
- 2
Confirm your enrollment window
Review your Initial Enrollment Period or ask whether a Special Enrollment Period applies to your situation.
- 3
Apply through Social Security
You can apply through Social Security online or contact Social Security for help with your application.
Part B coverage
What Part B generally covers
Part B focuses on medical and outpatient care. A service usually must meet Medicare coverage and medical necessity rules.
Commonly covered
- Doctor visits and specialist care
- Outpatient tests, procedures, and therapies
- Preventive services and screenings
- Certain home health services
- Certain durable medical equipment
Common limitations
- Most routine dental care
- Routine eye exams for glasses
- Hearing aids and related fitting exams
- Most long term custodial care
- Services that do not meet Medicare requirements
Ask your provider whether Medicare is expected to cover a service before you receive care.
Part B basics
Costs and eligibility at a glance
Part B has a monthly premium and generally leaves part of the cost of covered services for you to pay.
Monthly premium
Most people pay a Part B premium
The amount can change each year and may be higher based on income.
Your share of costs
A deductible and coinsurance may apply
After the annual deductible, you usually pay part of the Medicare approved amount for covered services.
Eligibility
Part B follows Medicare eligibility rules
People may qualify at age 65 or earlier because of certain disabilities or health conditions.
Part B enrollment
Make your timing decision carefully
Delaying Part B without qualifying coverage can lead to a coverage gap or a late enrollment penalty.
- 1
Review your current coverage
If you or your spouse is still working, ask the employer benefits administrator how that coverage works with Medicare.
- 2
Identify the right enrollment period
Your Initial Enrollment Period, a Special Enrollment Period, or another Medicare enrollment period may apply.
- 3
Complete your application
Apply through Social Security online, by phone, or through your local Social Security office.
Compare the basics
Part A and Part B at a glance
The two parts cover different types of care and usually work together.
| Feature | Part A | Part B |
|---|---|---|
| Primary role | Hospital insurance | Medical insurance |
| Common services | Inpatient hospital, limited skilled nursing, hospice, and certain home health care | Doctor visits, outpatient care, preventive services, and certain medical equipment |
| Monthly premium | Many people qualify without a premium, but not everyone | Most people pay a monthly premium |
| Cost sharing | Deductibles and coinsurance may apply by benefit period | An annual deductible and coinsurance may apply |
Costs and coverage rules can change. Check current Medicare information before making a decision.
Original Medicare leaves some costs for you to pay
A Medicare Supplement policy, also called Medigap, may help with certain deductibles, coinsurance, and copayments that Original Medicare does not pay.
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Original Medicare questions
Clear answers about Parts A and B
Start with the questions that matter most to you.
Costs
Enrollment
Coverage
Personalized guidance
Talk through your Original Medicare questions
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