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Original Medicare: What Parts A and B Cover

The foundation of all Medicare coverage: hospital insurance and medical insurance, what each pays for, and what they leave out.

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Part A: hospital insurance

Part A covers inpatient hospital stays, care in a skilled nursing facility after a hospital stay, hospice care, and some home health care. Most people pay no monthly premium for Part A, because they or a spouse paid Medicare taxes while working.

Part B: medical insurance

Part B covers doctor visits, outpatient care, preventive services like screenings and annual wellness visits, lab tests, and durable medical equipment. Part B carries a monthly premium for most people, and you generally pay 20 percent of the cost of covered services after an annual deductible. Both figures are set by Medicare and change each year — ask us and we will tell you what applies right now.

The important gap: Original Medicare has no yearly limit on what you can pay out of pocket, and it does not cover most prescription drugs, dental, vision or hearing. That is why most people pair it with a Supplement and a Part D plan, or choose a Medicare Advantage plan instead.

What you pay

Part A
Usually no premium. A deductible applies per hospital benefit period.
Part B
A monthly premium plus about 20 percent of covered costs, with no annual cap.
Want to know what this means for your budget?
A licensed agent will walk through the numbers for your situation.