Medicare Part A is hospital insurance. It pays for inpatient stays, skilled nursing facility care, hospice, and limited home health services. Medicare Part B is medical insurance. It pays for doctor visits, outpatient procedures, preventive screenings, and durable medical equipment like wheelchairs or oxygen tanks. Most people get Part A premium-free based on work history, while nearly everyone pays a monthly premium for Part B, $202.90 in 2026 for most enrollees. Together, Part A and Part B make up Original Medicare. Understanding the split matters because it determines what you pay out of pocket and whether you need extra coverage, like a Medigap policy or Medicare Advantage plan, to fill the gaps.
This guide breaks down exactly what each part covers, what it costs in 2026, and how to decide whether Original Medicare alone is enough for your situation.
What Medicare Part A Covers
Part A is often called "hospital insurance," but its coverage extends beyond a hospital room. It includes:
- Inpatient hospital care: A semi-private room, meals, general nursing, drugs administered during your stay, and other hospital services and supplies.
- Skilled nursing facility (SNF) care: Care after a qualifying hospital stay of at least three days, limited to 100 days per benefit period, and only when skilled care is medically necessary (not custodial or long-term care).
- Hospice care: For terminally ill patients with a life expectancy of six months or less, including pain management and support services. Most hospice care under Part A has little to no cost.
- Home health care: Part-time or intermittent skilled nursing care, physical therapy, and other services when ordered by a doctor and you're homebound.
Part A does not cover long-term custodial care in a nursing home, most dental care, eyeglasses, or hearing aids.
Part A Costs in 2026
| Item | 2026 Cost |
|---|
| Monthly premium (40+ work quarters) | $0 |
| Monthly premium (30 to 39 work quarters) | $311 |
| Monthly premium (fewer than 30 quarters) | $565 |
| Inpatient hospital deductible (per benefit period) | $1,736 |
| Hospital coinsurance, days 61 to 90 | $434/day |
| Hospital coinsurance, lifetime reserve days (61 max, days 91+) | $868/day |
| Skilled nursing facility coinsurance, days 21 to 100 | $217/day |
A "benefit period" starts the day you're admitted as an inpatient and ends after you've been out of the hospital or a skilled nursing facility for 60 days in a row. That means the $1,736 deductible can apply more than once in a single year if you have separate hospital stays that are more than 60 days apart.
What Medicare Part B Covers
Part B is "medical insurance," and it covers the care you get outside a hospital bed. That includes:
- Doctor visits: Primary care and specialist appointments, whether in an office or as an outpatient at a hospital.
- Outpatient care: Emergency room visits, outpatient surgery, lab tests, and X-rays.
- Preventive services: Annual wellness visits, flu shots, cancer screenings, diabetes screenings, and cardiovascular disease screenings, most at no cost when you use a provider who accepts assignment.
- Durable medical equipment (DME): Wheelchairs, walkers, oxygen equipment, and hospital beds prescribed for home use.
- Mental health services: Outpatient counseling, psychiatric evaluations, and some substance use disorder treatment.
- Ambulance services and some outpatient prescription drugs administered in a clinical setting, such as chemotherapy infusions.
Part B generally does not cover routine dental, vision, or hearing care, and it doesn't cover most outpatient prescription drugs you'd pick up at a pharmacy, that's what Part D is for.
Part B Costs in 2026
| Item | 2026 Cost |
|---|
| Standard monthly premium | $202.90 |
| Annual deductible | $283 |
| Coinsurance after deductible | 20% of the Medicare-approved amount |
| Higher-income premium range (IRMAA) | $284.10 to $689.90/month |
Once you meet the $283 annual deductible, Medicare typically pays 80% of the approved amount for covered services and you're responsible for the remaining 20%, with no annual out-of-pocket cap under Original Medicare. That uncapped 20% is the main reason many people pair Part B with a Medigap supplement or choose a Medicare Advantage plan instead.
If your modified adjusted gross income from two years prior exceeds $109,000 (single) or $218,000 (married filing jointly), you'll pay an Income-Related Monthly Adjustment Amount (IRMAA) on top of the standard Part B premium. This surcharge is recalculated annually based on your tax return from two years earlier.
Part A vs Part B: Side-by-Side Comparison
| Feature | Part A | Part B |
|---|
| Common name | Hospital insurance | Medical insurance |
| Covers | Inpatient hospital, SNF, hospice, some home health | Doctor visits, outpatient care, preventive services, DME |
| Standard 2026 premium | $0 for most people | $202.90/month |
| 2026 deductible | $1,736 per benefit period | $283 per year |
| Cost sharing after deductible | Varies by service and day count | 20% coinsurance, no cap |
| Enrollment | Often automatic if collecting Social Security | Often automatic if collecting Social Security |
| Late enrollment penalty | Rare, only if you owe a premium and delay | 10% per 12-month period you were eligible but didn't enroll |
How Part A and Part B Work Together
Original Medicare is Part A plus Part B. Neither one alone gives you complete coverage. If you only had Part A, an outpatient doctor visit or an X-ray wouldn't be covered. If you only had Part B, an inpatient hospital stay wouldn't be covered. Most people who choose Original Medicare enroll in both, then decide whether to add:
- A Medicare Supplement (Medigap) policy to help cover the deductibles, coinsurance, and copays that Part A and Part B leave behind.
- A standalone Part D plan for prescription drug coverage, since neither Part A nor Part B covers most retail prescriptions.
- A Medicare Advantage (Part C) plan as an alternative that bundles Part A, Part B, and usually Part D into one plan through a private insurer, often with added benefits like dental or vision, but typically with a network of providers.
When You're Eligible and How to Enroll
You're generally eligible for Medicare at age 65 if you or your spouse worked and paid Medicare taxes for at least 10 years (40 quarters). People under 65 may qualify earlier if they've received Social Security Disability Insurance (SSDI) for 24 months, or if they have End-Stage Renal Disease or ALS.
Initial Enrollment Period: A seven-month window that starts three months before the month you turn 65, includes your birthday month, and ends three months after.
If you're already collecting Social Security, you're typically enrolled in Part A and Part B automatically, and your Medicare card arrives a few months before you turn 65.
If you're not yet collecting Social Security, you need to sign up yourself through the Social Security Administration, either online at ssa.gov, by phone, or in person.
Working past 65 with employer coverage: If you or your spouse has coverage through a job at a company with 20 or more employees, you can often delay Part B without a penalty until that coverage ends, then use a Special Enrollment Period. Company size matters here, so check with your employer's benefits office before deciding to delay.
Missing your enrollment window without qualifying coverage triggers a General Enrollment Period from January 1 to March 31 each year, with coverage starting the month after you enroll, and a late enrollment penalty that can follow you for as long as you have Part B.
Frequently Asked Questions
Can I have Part A without Part B?
Yes. Some people, especially those still working with employer coverage, take premium-free Part A and delay Part B to avoid paying two premiums for overlapping coverage. Since Part A is free for most people based on work history, there's rarely a reason to decline it.
Can I have Part B without Part A?
It's uncommon but possible, mainly for people who don't qualify for premium-free Part A and don't want to pay the Part A premium. Most people in this situation still enroll in both if they can afford it, since Part A covers hospitalization risk that Part B doesn't touch.
Does Part A or Part B cover prescription drugs?
Neither covers most retail prescription drugs. Part B covers certain drugs administered in a clinical setting, like injections given during a doctor's visit. For prescriptions you pick up at a pharmacy, you need a separate Part D plan or a Medicare Advantage plan that includes drug coverage.
What happens if I don't sign up for Part B when I'm first eligible?
If you don't have coverage through an employer, you'll likely face a permanent late enrollment penalty: your premium increases 10% for each full 12-month period you were eligible but didn't enroll. You'll also have to wait for the General Enrollment Period to sign up, which can leave you without coverage for months.
Does Medicare Part A or Part B cover long-term nursing home care?
No. Part A covers short-term skilled nursing facility care after a qualifying hospital stay, up to 100 days, but not ongoing custodial care like help with bathing or dressing. Long-term nursing home care typically falls to Medicaid once someone meets that program's income and asset limits, or to private long-term care insurance.
How much does Medicare Part A and Part B cost together in 2026?
For someone with premium-free Part A, the main recurring cost is the Part B premium of $202.90 a month. Add the $283 Part B deductible and the $1,736 Part A hospital deductible if you're admitted, plus 20% coinsurance on outpatient services with no cap, and total costs can add up quickly during a serious illness. This is why many beneficiaries pair Original Medicare with a Medigap policy or choose Medicare Advantage instead.
