Medicare Part A vs Part B: What Each One Covers

When people first hear about Medicare, they often think of it as one big insurance plan. In reality, Medicare is split into parts — and the two most foundational pieces are Part A and Part B. Together, they form what is called Original Medicare.

Understanding the difference between these two parts is one of the first steps in building a Medicare plan that actually works for your life.

What Does Medicare Part A Cover?

Part A is sometimes called hospital insurance because its primary role is covering inpatient care. Here is what falls under Part A:

• Inpatient hospital stays — including semiprivate rooms, meals, nursing care, and medications administered during your stay
• Skilled nursing facility care — but only after a qualifying hospital stay of at least three days, and only for a limited time
• Hospice care — for people who are terminally ill and choose comfort-focused care
• Some home health services — when medically necessary and ordered by a doctor

What Part A Costs

Most people pay no monthly premium for Part A because they (or their spouse) paid Medicare taxes during their working years. However, Part A still has a deductible — in 2026, the inpatient hospital deductible is $1,736 per benefit period. After that, coinsurance applies for extended stays.

This is one area where supplemental coverage, like a Medigap plan, can be particularly valuable.

What Does Medicare Part B Cover?

Part B is sometimes called medical insurance because it covers a broader range of outpatient and preventive services:

• Doctor visits and consultations
• Outpatient procedures and surgeries
• Preventive screenings — such as flu shots, mammograms, colonoscopies, and annual wellness visits
• Lab tests and diagnostic imaging
• Durable medical equipment — like wheelchairs, walkers, and oxygen equipment
• Mental health services — both outpatient therapy and some inpatient psychiatric care
• Ambulance services when medically necessary

What Part B Costs

Part B has a standard monthly premium, which is $202.90 per month for most people in 2026. Higher-income enrollees pay more through an Income-Related Monthly Adjustment Amount (IRMAA). There is also an annual deductible ($283 in 2026) and a standard 20% coinsurance for most services.

That 20% coinsurance is uncapped — meaning for expensive services, your share can be significant. This is another area where Medigap coverage is often considered.

• Part A covers inpatient hospital care, skilled nursing, and hospice — most people pay no premium but do face deductibles.
• Part B covers doctor visits, outpatient care, and preventive services — there is a monthly premium and a 20% coinsurance for most services.
• Both parts have cost-sharing gaps — which is why many people add supplemental or Medicare Advantage coverage.

How Part A and Part B Work Together

Part A and Part B are designed to complement each other. Part A handles the bigger, less frequent expenses (hospital stays), while Part B handles the ongoing, everyday medical needs (doctor visits, labs, procedures).

When people talk about Original Medicare, they are referring to having both Part A and Part B active. From there, you can choose to add:

• A Medigap (Medicare Supplement) policy to help cover Part A and Part B cost-sharing
• A Part D plan for prescription drug coverage
• Or enroll in a Medicare Advantage plan that bundles all of these together

If you are weighing these choices, talking with someone who understands how the pieces fit can save time and reduce confusion. Summit Benefits Group walks Kentucky clients through these comparisons every day.

What Is NOT Covered by Part A or Part B?

Even with both parts, there are common healthcare needs that Original Medicare does not cover:

• Routine dental care (cleanings, fillings, extractions)
• Routine vision care (eye exams, glasses, contacts)
• Hearing aids and routine hearing exams
• Most prescription drugs (covered under Part D)
• Long-term custodial care (such as assisted living)
• Cosmetic surgery
• Care received outside the United States (with limited exceptions)

These gaps are important to understand because they influence what additional coverage you may want to consider.

Part A and Part B: Common Questions

Related Reading

If you are still getting oriented, what Medicare is and how it works gives you the wider frame, and our plain-English starting point for people new to Medicare is a gentler on-ramp. Because Parts A and B leave prescriptions out, most people pair them with Medicare Part D drug coverage.

Understanding Part A and Part B is the starting point for every Medicare decision. At Summit Benefits Group, we help Kentucky residents review what Original Medicare covers, where the gaps are, and what supplemental options make sense for their situation.

We take the time to explain the details — not just the headlines — so you can make choices that actually fit your healthcare needs and budget.