Medicare Part A & Part B (Original Medicare)

Understanding the Foundation of Medicare

Understanding Medicare can feel like trying to read a map with half the roads missing. That’s where I come in.

Medicare Part A and Part B, together, are known as Original Medicare. They provide the foundation of your Medicare coverage, but they don't cover everything.

Here's how they work.

What is Medicare Part A?

Medicare Part A is your hospital coverage. It helps pay for:

  • Inpatient hospital stays

  • Skilled nursing facility care

  • Hospice care

  • Some home health services

Most people don't pay a monthly premium for Part A because they or their spouse paid Medicare taxes while working long enough to qualify. Generally, that means at least 10 years, or 40 quarters, of Medicare-covered employment.

What is Medicare Part B?

Medicare Part B is your medical coverage. It helps pay for things like:

  • Doctor visits

  • Preventive services, including screenings and vaccines

  • Outpatient care

  • Lab work, X-rays, and other diagnostic services

  • Durable medical equipment, such as walkers and wheelchairs

  • Certain home health services

Part B has a monthly premium, and the amount can be higher depending on your income.

What Doesn't Original Medicare Cover?

While Parts A and B cover a lot, they don't cover everything.

With Original Medicare, you can still have:

  • Deductibles

  • Copayments and coinsurance

  • No built-in prescription drug coverage

  • No yearly limit on what you may have to pay for covered Part A and Part B services

For example, Part B generally pays 80% of the Medicare-approved amount for covered services after you meet your annual deductible, leaving you responsible for the remaining 20%. There is no annual out-of-pocket maximum under Original Medicare.

That's why many people choose additional coverage, such as a Medicare Supplement plan, a Medicare Advantage plan, and/or a Medicare Part D prescription drug plan.

What Does Original Medicare Cost in 2026?

The costs of Original Medicare generally fall into three categories: premiums, deductibles, and coinsurance or copayments.

Part A Premium

For most people, Part A is $0 per month because they have enough Medicare-covered work history.

If you don't qualify for premium-free Part A, you may be able to purchase Part A. In 2026, the monthly premium can be $311 or $565, depending on your work history.

Part A Hospital Costs

In 2026:

  • $1,736 deductible for each hospital benefit period

  • $0 per day for days 1–60 after the deductible

  • $434 per day for days 61–90

  • $868 per day for days 91–150 when using lifetime reserve days

  • After day 150, you pay all costs

For example, a 90-day inpatient hospital stay could result in $14,756 in Part A cost-sharing under Original Medicare, assuming the entire stay is covered by Part A.

Skilled Nursing Facility Costs

For covered skilled nursing facility care in 2026:

  • $0 per day for days 1–20

  • $217 per day for days 21–100

  • After day 100, you pay all costs

That's potentially $17,360 in coinsurance alone for days 21–100.

Part B Premium

The standard Part B premium in 2026 is $202.90 per month, although people with higher incomes may pay more.

You generally pay the Part B premium every month, whether or not you receive Part B-covered services.

Part B Annual Deductible

The 2026 Part B deductible is $283.

After you meet the deductible, you generally pay 20% of the Medicare-approved amount for covered Part B services, while Medicare pays 80%.

How I Help

At Mainely Medicare Help, I make Medicare easier to understand.

I can help you:

  • Understand exactly what Medicare Parts A and B cover, and what they don't

  • Understand when you need to enroll and help you avoid late enrollment penalties

  • Compare your options for additional Medicare coverage

  • Understand how Medicare Advantage, Medicare Supplement, and Part D fit with Original Medicare

  • Consider your doctors, prescriptions, healthcare needs, and budget

  • Make sense of the Medicare alphabet without the insurance jargon

No pressure. No confusing sales pitch. Just clear guidance so you can make an informed decision with confidence.

For official information about Medicare costs, visit Medicare.gov: What Does Medicare Cost?.

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