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Medicare 101: How Parts A and B Work

Medicare 101

Everything Centers Around Medicare Parts A & B!

Helpful Medicare tips

It is very common for people to be confused by Original Medicare. The easiest way to understand Medicare is to understand the different parts of Original Medicare.

Medicare Parts A & B can be looked at as the centerpieces that everything else revolves around. They are the only two pieces that actually come from the government. All other parts you hear about come from private insurance companies

What Is Medicare Part-A?

Medicare Part A is hospital insurance. It covers inpatient hospital stays, care in a skilled nursing facility after a qualifying 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 for at least 10 years (40 quarters); people with 30 to 39 quarters pay $311 a month in 2026 and people with fewer than 30 quarters pay $565.

Part A is not free to use. In 2026 you pay a $1,736 deductible for each benefit period, $434 a day for hospital days 61 to 90, $868 a day for the 60 lifetime reserve days, and $217 a day for skilled nursing days 21 to 100. A benefit period starts the day you are admitted and ends when you have been out of the hospital or skilled nursing facility for 60 days in a row, so the deductible can apply more than once a year. Source: CMS, 2026 Medicare Parts A & B premiums and deductibles.

Medicare Part A hospital insurance

What Is Medicare Part-B?

Medicare Part-B is (for the most part) going to include your outpatient services. These can be described as doctors visits, outpatient surgeries, lab work, outpatient x-rays, durable medical equipment (such as wheelchairs and oxygen tanks), ambulance services, amongst other things. Medicare Part-B is like the other side of the coin to Medicare Part-A. What Part-A does not cover on the medical side, Part-B typically does.

Medicare Part B medical insurance

What Does Original Medicare Not Cover?

What does Original Medicare not cover? Plenty! Original Medicare on its own does not cover prescription drugs that would be filled at a pharmacy. It does not cover things like dental, vision, or hearing. Believe it or not, Original Medicare does not cover a traditional physical after you have been on Original Medicare longer than 12 months. Original Medicare provides you with a "Welcome to Medicare" physical in the first year of being an Original Medicare recipient, but after that never again. Original Medicare covers what is known as a Wellness visit, but it is best described as a less detailed physical.

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Original Medicare has two parts from the federal government: Part A (hospital insurance, premium-free for most people, $1,736 deductible per benefit period in 2026) and Part B (medical insurance, $202.90 a month, $283 annual deductible, then 80/20). Everything else, Medicare Advantage, Medigap and Part D, comes from private insurers and builds on A and B.

Questions people ask about Medicare 101: How Parts A and B Work

What are the parts of Original Medicare?

Original Medicare has two parts that come from the federal government: Part A (hospital insurance) and Part B (medical insurance). Medicare Advantage (Part C), Part D drug plans and Medigap are offered by private insurance companies.

What does Medicare Part B cover?

Part B covers outpatient services: doctor visits, outpatient surgery, lab work, X-rays, durable medical equipment such as wheelchairs and oxygen, ambulance services and preventive care. It generally pays 80% of the Medicare-approved amount after the annual deductible.

What does Original Medicare not cover?

Original Medicare does not cover prescription drugs filled at a pharmacy, routine dental, vision or hearing care, or a traditional annual physical after the first-year Welcome to Medicare visit; it covers an annual Wellness visit instead.

Does Everything Senior Insurance charge for Medicare guidance?

No. Helping you understand Parts A and B and compare the private plans that fill the gaps is free; the agency is paid by the carrier you choose.

What does Medicare Part A cost in 2026?

Most people pay no Part A premium. The 2026 inpatient hospital deductible is $1,736 per benefit period, with $434 a day for days 61 to 90, $868 a day for lifetime reserve days and $217 a day for skilled nursing days 21 to 100.

Last updated: · Reviewed by Christian Brindle, CEO and Founder. Published by the Everything Senior Insurance Data Desk. Sources: Medicare Part A and Part B coverage, Medicare.gov.