Understanding Medicare > Medicare Coverage & Benefits

Medicare Part A and B Coverage

Written by:

Aaron Garcia

Reviewed by:

Michael Howard

5 min read

Key Takeaways

Original Medicare is also known as Medicare Part A and Part B.
Medicare Part BMedicare Part B is medical insurance that covers Medicare-approved services — such as medically necessary treatment and preventive services — and certain other costs, like durable medical equipment. Medicare Part B is part of Original Medicare. covers medical care, such as doctor visits and outpatient therapy.
Medicare Part AMedicare Part A is hospital insurance, which covers the care you receive while admitted to a hospital, skilled nursing facility, or other inpatient facility. Medicare Part A is part of Original Medicare. covers hospital and facility costs.

What Does Medicare Part A and B Cover?

Medicare Part A

Medicare Part A is hospital insurance, which can cover inpatient care in a:

Hospital
Skilled nursing facility
Nursing home care (when needed for short-term rehabilitation; not long-term)
Psychiatric hospital
Some home health care
Hospice care

Your care is covered if you’re admitted to a facility that accepts Medicare after receiving an official doctor’s order saying you need inpatient treatment.

After the costs for a hospital stay exceed the Part A deductibleA deductible is an amount you pay out of pocket before your insurance company covers its portion of your medical bills. For example: If your deductible is $1,000, your insurance company will not cover any costs until you pay the first $1,000 yourself. (which is determined each year by the federal government), Medicare pays your costs for the first 60 days. For longer stays, you will pay a set amount each day.

Medicare Part B

Medicare Part B covers your doctor visits and other services. When you go to a healthcare provider who accepts Medicare, your Part B coverage includes:

The Part B deductible may go up or down year-to-year. Once you reach the deductible amount, you’re charged a copayment or coinsurance for the rest of your benefit year, usually 20% of the Medicare-approved amount for most services.

Have questions about your Medicare coverage?

A drawing of a person selecting an option

What Does Medicare Part A and Part B NOT Cover?

Examples of care that are not covered by Part A or Part B include:

If you need a service that is not included in Medicare Part A and B coverage, you may need to pay out of pocket or consider a Medicare Advantage plan with additional benefits.

What Else Might I Consider?

Prescription Drug Plan

Original Medicare (Parts A and B) does not cover most prescription drugs. You can add a Medicare prescription drug plan (Medicare Part D) from a private insurance carrier to cover prescription drugs.

Medigap Medicare Supplement Insurance

Private insurance carriers offer Medigap Medicare Supplement Insurance plans to cover out-of-pocket costs not picked up by Part A or Part B coverage. In most states, you have many coverage options, which offer different levels of protection.

Medicare Advantage

Also known as Medicare Part C, Medicare Advantage plans are offered by private insurance carriers. They substitute for Original Medicare and must at least match the coverage provided by Part A and Part B.

Medicare Advantage Prescription Drug (MAPD) plans include Part D coverage. Plans may offer a variety of other benefits. Every plan has an out-of-pocket maximum that limits how much you’ll spend on covered services in a year.

Most Medicare Advantage plans have a provider network. To get the most out of your coverage, you’ll need to see healthcare providers and visit pharmacies that are included in that network.