Medicare Part A and Part B are the two parts that make up “Original Medicare.”
Let’s take a look at Medicare Part A vs. Part B to see how they differ in terms of coverage, cost, eligibility and more.
Medicare Part A is hospital insurance.
Part A covers many of the costs for your covered inpatient care at:
Some of the items and services that Medicare Part A covers while you’re admitted as an inpatient can include:
Part A covers skilled nursing care you receive in a skilled nursing facility (SNF). The services that Part A covers can include (but aren’t limited to):
Part A covers certain home health care services if you meet specific requirements, such as being homebound or having a doctor certify that you need intermittent skilled nursing care at home.
Part A also provides coverage for hospice care, which can include (but aren’t limited to) services such as:
Check with your doctor to learn more about how Medicare Part A may or may not cover your services.
Most people do not pay a premium for their Part A coverage.
Medicare Part A premiums are based on how many years you worked and paid Medicare taxes.
Medicare Part A also includes a deductible of $1,364 per benefit period (in 2019), which is not annual. This means that you could potentially be required to pay the Part A deductible more than once in a year.
If you are admitted to a hospital for inpatient care, you must first meet your Part A deductible for each given benefit period before your Part A coverage kicks in.
If your hospital stay lasts for more than 60 days, you will pay the following Part A coinsurance costs in 2019:
You only have 60 lifetime reserve days to use in your lifetime. Once you use them, they are gone.
Medicare Part B is medical insurance.
Part B covers outpatient care, which can include:
Part B covers durable medical equipment (DME), which can include things like wheelchairs, crutches, blood sugar test strips and other equipment that your doctor prescribes for use in your home.
Medicare Part B also covers some preventive care services, which can include (but aren’t limited to):
You should talk to your doctor or health care provider to find out more about how Medicare may or may not cover your tests, screenings or health care services and devices.
The standard Part B premium in 2019 is $135.50 per month.
Part B premiums are based on your reported modified adjusted gross income (MAGI) from two years prior. So your 2019 Part B premiums are based on your reported income from 2017.
Individuals with a reported income of less than $85,000 per year and couples with a combined income of less than $170,000 per year pay the standard Part B premium of $135.50 per month.
Anyone with incomes above those thresholds pay more for their Part B coverage based on the Income-Related Monthly Adjusted Amount, or Medicare IRMAA.
The table below breaks down 2019 Medicare Part B premiums according to income.
|2017 Individual tax return||2017 Joint tax return||2017 Married and separate tax return||2019 Part B premium|
|$85,000 or less||$170,000 or less||$85,000 or less||$135.50|
|More than $85,000 and up to $107,000||More than $170,000 and up to $214,000||N/A||$189.60|
|More than $107,000 up to $133,500||More than $214,000 up to $267,000||N/A||$270.90|
|More than $133,500 up to $160,000||More than $267,000 up to $320,000||N/A||$352.20|
|More than $160,000 up to $500,000||More than $320,000 up to $750,000||More than $85,000 up to $415,000||$433.40|
|More $500,000||More than $750,000||More than $415,000||$460.50|
The premiums for Part A and Part B can potentially increase every year.
Part B also includes a deductible, which is $185 per year in 2019.
After you meet your Part B deductible, you typically pay 20 percent of the Medicare-approved amount for most covered services. This is called the Part B coinsurance or copayment.
In order to be eligible for Medicare Part A and/or Part B, you must meet each of the following eligibility requirements:
As mentioned above, Medicare Part B is optional.
Some people are automatically enrolled in Medicare Part A and Part B. You are typically automatically enrolled if you’re already receiving Social Security or Railroad Retirement Board retirement benefits when you turn 65.
If you’re under 65 and eligible for Medicare due to a disability, you’ll be automatically enrolled the 25th month you’ve been receiving Social Security disability benefits.
*Note: If you do not sign up for Part B when you first become eligible, you may be subject to a Part B late enrollment penalty if you choose to sign up at a later time.
Original Medicare doesn’t typically cover prescription drugs. Part A and Part B also don’t cover certain health care services such as:
If you want coverage for prescription drugs or other health services not covered by Original Medicare, you may have to pay entirely out of pocket.
Some Medicare Advantage plans (Medicare Part C), however, may offer coverage for services not covered by Original Medicare.
Medicare Advantage plans are sold by private insurance companies and cover everything that Part A and Part B cover.
Part C plan availability can vary from one location to the next. A licensed insurance agent can help you compare Medicare Advantage plans that may be available where you live.
Find Medicare Advantage plans in your areaCompare Plans
Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.
Copyright © 2019 TZ Insurance Solutions LLC. All rights reserved.
MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.
Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
Medicare has neither reviewed nor endorsed this information.