Medicare Part A covers hospital stays, skilled nursing, and hospice care

Medicare Part A is hospital insurance. It pays for inpatient hospital stays, skilled nursing facility care after a hospital stay, hospice services, and some home health care. You do not pay a monthly premium for Part A if you or your spouse paid Medicare taxes for at least 10 years while working. Most people age 65 and older get Part A automatically.

Part A has a deductible you pay once per benefit period — a span of time that starts when you enter the hospital and ends 60 days after you leave. In 2024, that deductible is $1,676 for each benefit period. After you meet the deductible, Medicare covers all approved hospital costs for the first 60 days. Days 61 through 90 require a daily coinsurance amount. Beyond 90 days, you pay the full cost unless you use lifetime reserve days, which are limited.

For skilled nursing facility care — not regular nursing home care, but care that follows a hospital stay and involves medical treatment — Part A covers the first 20 days fully. Days 21 through 100 require a daily coinsurance payment. After 100 days in a benefit period, you pay everything yourself.

Medicare Part B covers doctor visits, outpatient care, and medical equipment

Medicare Part B is medical insurance. It covers doctor visits, outpatient hospital services, diagnostic tests, physical therapy, mental health services, ambulance transport, and durable medical equipment like wheelchairs and oxygen. Part B also covers preventive care such as cancer screenings and annual wellness visits at no cost to you.

Part B requires a monthly premium, which varies by income. In 2024, the standard premium is $164.90 per month for most people, though higher earners pay more. You also pay a yearly deductible — $240 in 2024 — before Part B coverage begins. After you meet the deductible, you typically pay 20 percent of the approved cost for most services, and Medicare pays 80 percent.

Part B does not cover routine dental care, vision exams for glasses, hearing aids, or long-term custodial care in a nursing home. It also does not cover services deemed not medically necessary by Medicare, such as cosmetic surgery or experimental treatments not yet approved.

Key Takeaways

  • Part A covers hospital stays and skilled nursing care after hospitalization, with no monthly premium for most people but a per-stay deductible.
  • Part B covers doctor visits, outpatient services, and preventive care, with a monthly premium and yearly deductible that explore before Medicare shares costs.
  • Part A and Part B work together: Part A handles inpatient care, and Part B handles outpatient and doctor services.
  • Both parts have cost-sharing — deductibles, coinsurance, or copayments — that you pay before or after Medicare's coverage kicks in.
  • Part A and Part B do not cover dental, vision, hearing aids, or long-term nursing home care, which is why many people add supplemental coverage.

How Part A and Part B work together

Part A and Part B are designed to cover different settings. Part A pays for care you receive as an inpatient — meaning you are admitted to a hospital or skilled nursing facility and stay overnight. Part B pays for care you receive as an outpatient — meaning you go to a doctor's office, hospital outpatient department, or lab and return home the same day.

When you have a hospital stay covered by Part A, Part B still covers your doctor's services during that stay. The two parts do not duplicate payment; instead, they divide responsibility. Part A handles the facility costs, and Part B handles the physician fees. This means you may owe cost-sharing to both parts during a single hospital admission.

What you pay out of pocket with Part A and Part B

Your out-of-pocket costs depend on which part covers your care and what type of service you receive. For Part A hospital stays, you pay a deductible per benefit period, then coinsurance for days 61 through 90. For skilled nursing, you pay nothing for days 1 through 20, then coinsurance for days 21 through 100. For Part B, you pay a yearly deductible, then 20 percent coinsurance for most services after that.

These costs can add up quickly during a serious illness or long hospital stay. Many people buy Medigap (supplemental insurance) or enroll in Medicare Advantage (Part C) to reduce out-of-pocket expenses. Medigap policies are sold by private insurers and help pay deductibles and coinsurance. Medicare Advantage plans are an alternative to Original Medicare (Part A and B) and often include prescription drug coverage and dental or vision benefits, though they typically have network restrictions.

Part A and Part B do not cover everything

Original Medicare — Part A and Part B together — has significant gaps. Prescription drugs are not covered by either part; you need Part D (prescription drug coverage) for that. Long-term care in a nursing home, assisted living, or your own home is not covered. Dental work, routine eye exams, and hearing aids are not covered. Neither part covers medical care outside the United States, with rare exceptions.

Experimental treatments, cosmetic procedures, and services Medicare deems not medically necessary are also excluded. If you need these services, you pay the full cost yourself. Understanding these limits helps you plan for additional coverage or savings.

When Part A and Part B coverage begins

If you are already receiving Social Security benefits when you turn 65, Medicare Part A and Part B start automatically on the first day of the month you turn 65. If you are not yet receiving Social Security, you must sign up for Medicare during your initial enrollment period, which is the three months before the month you turn 65, the month you turn 65, and the three months after.

If you miss this window and do not have other may have access to coverage, you may face a permanent penalty on your Part B premium. The penalty is 10 percent of the standard premium for each full year you could have had Part B but did not sign up. This penalty stays with you for life, so enrolling on time matters.

Frequently Asked Questions

Do I have to take Part B if I have Part A?

No. Part A and Part B are separate. However, if you delay Part B enrollment without may have access to coverage, you will pay a permanent premium penalty. If you are still working and have employer health insurance, you may be able to delay Part B without penalty — ask your employer's benefits office whether your plan qualifies.

What is the difference between Original Medicare and Medicare Advantage?

Original Medicare is Part A and Part B. Medicare Advantage (Part C) is an alternative sold by private insurers that includes Part A and Part B benefits plus usually Part D (drugs) and sometimes dental or vision. Advantage plans have networks and may require prior authorization, while Original Medicare lets you see any provider who accepts Medicare.

Can I use Part A and Part B outside the United States?

Generally no. Medicare covers care only in the United States, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. If you travel abroad, you pay out of pocket unless you buy supplemental travel insurance that covers international care.

What happens if I do not have Part B?

You can still use Part A for hospital stays. However, you will not have coverage for doctor visits, outpatient services, or preventive care. You would pay the full cost of these services yourself unless you have other insurance.

How do deductibles work across Part A and Part B?

Part A and Part B have separate deductibles. You pay Part A's deductible once per benefit period for hospital care. You pay Part B's deductible once per calendar year for outpatient services. Meeting one deductible does not count toward the other.