Hospital Insurance
Facility-based care
Think inpatient and qualifying facility care.
Original Medicare
Medicare Parts A & B, Clearly Explained.
Two parts. Different jobs. One foundation for understanding how Original Medicare works.
Explore how A & B work
Original
Medicare
One foundation
Medical Insurance
Doctors & outpatient care
Think medical services, tests, equipment, and outpatient care.
The One-Minute Foundation
Start with one simple distinction.
Part A and Part B often work together, but they cover different types of care.
Think inpatient
Part A follows facility-based care.
It commonly applies when you are formally admitted to a hospital or qualify for certain facility and home-based services.
Think medical
Part B follows doctors and outpatient care.
It commonly applies to medical services, tests, equipment, and care received without an inpatient admission.
The building you are in does not always tell you whether Part A or Part B applies.
Even at a hospital, Part A may apply when you are admitted as an inpatient, while Part B may apply when you receive outpatient or observation care. Ask: “Am I an inpatient or an outpatient?”
Coverage Explorer
Tap a care example. See which part usually applies.
These examples provide a quick starting point. Coverage still depends on Medicare rules and your situation.
Try the Coverage Explorer
Select one of the care examples below to see whether Medicare Part A or Part B usually applies.
Waiting for your selection
Which part of Medicare usually applies?
Choose any example on the left. This panel will update immediately.
Hospital Insurance
Part A commonly helps cover:
Important Part A conditions
Coverage may require a qualifying inpatient stay, physician certification, skilled care, or other Medicare eligibility rules.
Medical Insurance
Part B commonly helps cover:
Important Part B conditions
Services generally must be medically necessary, covered by Medicare, and provided by an eligible doctor, provider, or supplier.
How Payment Works
Follow a covered service from care to cost.
1
You receive covered care
2
The provider submits the claim
3
Medicare applies its approved amount
4
You pay your remaining share
Ask whether your provider accepts Medicare assignment.
Accepting assignment generally means the provider agrees to accept the Medicare-approved amount as full payment for a covered service.
2026 Cost Snapshot
The numbers that matter most.
Medicare costs can change each year. These are the standard 2026 amounts for Original Medicare.
Hospital Insurance
$0
Monthly premium for most people
Who usually qualifies for $0 Part A?
Most common path
You or your spouse worked and paid Medicare taxes long enough, generally at least 10 years or 40 quarters.
Other qualifying paths
You may qualify through a current or former spouse’s work record, or through certain disability or medical eligibility pathways. Social Security makes the final determination.
If you must buy Part A in 2026
The monthly premium is $311 with 30–39 quarters of Medicare-covered work or $565 with fewer than 30 quarters. In most cases, buying Part A also requires Part B.
$1,736
Inpatient hospital deductible per benefit period
See hospital and skilled nursing costs
Hospital days 1–60: $0 daily coinsurance after the Part A deductible.
Hospital days 61–90: $434 per day.
Lifetime reserve days: $868 per day while available.
Skilled nursing days 21–100: $217 per day when covered.
Medical Insurance
$202.90
Standard monthly premium
Why might the Part B premium be higher?
Higher income
An income-related monthly adjustment amount, commonly called IRMAA, may be added based on tax information Social Security receives from the IRS.
Late enrollment
If you delay Part B without qualifying for a Special Enrollment Period, the premium may increase by 10% for each full 12-month period you could have enrolled but did not. The penalty generally lasts as long as you have Part B.
A delayed enrollment is not always late
Coverage based on your or your spouse’s current employment may allow you to delay Part B without a penalty. Confirm your eligibility before postponing enrollment.
$283
Annual deductible
Usually 20%
Your share after the deductible for many covered services
The standard Part B premium and income-adjusted amounts can change each year.
Original Medicare has no yearly out-of-pocket maximum.
Supplemental coverage may help limit or pay some of the deductibles and coinsurance Original Medicare leaves behind.
Common Coverage Gaps
Parts A & B cover a lot, but not everything.
These services are commonly misunderstood or require separate coverage.
Most prescription drugs
Part D is generally used for outpatient prescription drug coverage.
Routine dental care
Cleanings, fillings, dentures, and most routine dental services are generally not covered.
Routine vision care
Routine eye exams for glasses and most eyewear are generally not covered.
Hearing aids
Hearing aids and fitting exams are generally not covered.
Most long-term care
Custodial care in a nursing home or community setting is generally not covered.
Most care outside the U.S.
Original Medicare generally has limited coverage outside the United States.
Why “generally” matters
Medicare may cover certain services when specific medical, eligibility, or treatment-related requirements are met. Always verify the exact service before receiving care.
Quick Clarity Check
Three Medicare statements worth correcting.
Open each statement to reveal the clearer answer.
AssumptionPart A is always completely free.Click to reveal the truth
Truth
Most people pay no monthly Part A premium, but Part A still has deductibles and coinsurance. Some people must also pay a monthly Part A premium.
AssumptionPart B covers all of my prescriptions.Click to reveal the truth
Truth
Part B covers only certain outpatient drugs in specific circumstances. Most outpatient prescriptions are handled through Medicare drug coverage.
AssumptionOriginal Medicare limits what I can spend each year.Click to reveal the truth
Truth
Original Medicare does not have a yearly out-of-pocket maximum unless other coverage helps limit or pay those costs.
Verify the Details
Official Medicare resources
Coverage and costs depend on the service, provider, medical necessity, and current Medicare rules.