What Is Medicare Part A and Part B?
Understanding Medicare Parts A and B is essential for seniors navigating healthcare coverage. These two parts form Original Medicare and cover different healthcare services. Knowing what each covers helps beneficiaries maximize their benefits.
Medicare Part A: Hospital Insurance
Part A covers inpatient care when you are admitted to hospitals. Room and board, nursing care, medications during your stay, and other hospital services are included. Part A pays for medically necessary inpatient treatment.
Skilled nursing facility care is covered following qualifying hospital stays. After at least three days of inpatient hospitalization, Medicare covers up to 100 days of skilled nursing care. Days 1-20 are fully covered; days 21-100 require daily copays.
Home health care falls under Part A when you need skilled services and are homebound. Nursing visits, physical therapy, occupational therapy, and speech therapy are covered. No prior hospitalization is required for home health benefits.
Hospice care for terminal illness is a Part A benefit. When patients choose comfort-focused care with a prognosis of six months or less, hospice provides comprehensive support including medications, equipment, and nursing care.
Most people pay no premium for Part A based on their work history or spouse’s work history paying Medicare taxes. Those without sufficient work history can purchase Part A coverage.
Medicare Part B: Medical Insurance
Part B covers outpatient medical services including doctor visits, preventive care, and medically necessary services outside of hospital admission. This coverage handles day-to-day medical needs.
Doctor and specialist visits are covered. Office appointments, consultations, and outpatient procedures fall under Part B. You can see any doctor accepting Medicare.
Preventive services including annual wellness visits, many screenings, and vaccinations are covered without cost-sharing. Taking advantage of these free preventive benefits supports early detection.
Outpatient procedures and surgeries performed without hospital admission are Part B services. Same-day surgeries and outpatient treatments are covered.
Durable medical equipment including wheelchairs, walkers, oxygen, and hospital beds is covered when medically necessary. Part B typically covers 80 percent after the deductible.
Part B requires monthly premiums deducted from Social Security. Standard premiums apply to most beneficiaries, with higher-income individuals paying more through income-related adjustments.
How Parts A and B Work Together
Part A and Part B complement each other. Part A handles inpatient care while Part B covers outpatient services. Together, they provide comprehensive medical coverage.
Gaps remain in Original Medicare. No prescription drug coverage is included. Cost-sharing through deductibles and coinsurance applies. Supplemental coverage addresses these gaps.
Getting Medicare Guidance
All Seniors Foundation helps seniors understand Medicare and access covered services. Maximizing benefits requires understanding them. Contact us for Medicare questions and help accessing home health and hospice benefits.
