Part A covers hospital care, Part B covers doctor visits and outpatient services

Medicare Part A pays for inpatient hospital stays, skilled nursing facility care after a hospital stay, hospice care, and some home health services. Medicare Part B pays for doctor office visits, outpatient hospital services, medical equipment, lab tests, and preventive care. Most people get both parts together, but they work separately — Part A handles what happens when you are admitted to a hospital, Part B handles what happens in a doctor's office or as an outpatient.

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. Part B has a monthly premium that changes each year; in 2024 it starts at $174.70 per month for most people, though higher earners pay more. Both parts have a deductible you pay before coverage begins, and both require you to pay a share of costs after that.

Key Takeaways

  • Part A covers hospital admissions, skilled nursing care after hospitalization, and hospice; Part B covers doctor visits, outpatient services, and preventive screenings.
  • Part A is usually free if you worked and paid Medicare taxes for 10 years; Part B requires a monthly premium that varies by income.
  • Each part has its own deductible and cost-sharing rules, so you may owe money even after Medicare pays its share.
  • You can enroll in both parts during your initial enrollment window when you turn 65, or during the General Enrollment Period from January through March each year.

What Part A covers and what you pay

Part A covers a hospital stay when you are admitted as an inpatient — meaning you stay overnight and occupy a hospital bed. It pays for your room, meals, nursing care, and most hospital services. The Part A deductible for 2024 is $1,632 per benefit period; you pay this amount before Part A begins to pay. After you meet the deductible, you pay nothing for days 1 through 60 of a hospital stay in the same benefit period. Days 61 through 90 cost you $408 per day. Days 91 and beyond cost you $816 per day, up to a lifetime reserve of 60 additional days.

Part A also covers skilled nursing facility care — a nursing home or rehabilitation center — but only if you were hospitalized first and the doctor orders the care as part of your treatment. You must have been in the hospital for at least three consecutive days. Part A covers all costs for days 1 through 20 of skilled nursing care in the same benefit period. Days 21 through 100 cost you $204 per day in 2024. After day 100, you pay all costs.

Part A covers hospice care when a doctor says you have six months or less to live and you choose comfort care instead of treatment. You pay nothing for hospice services, though you may pay a small copay for drugs and respite care. Part A also covers some home health services — nursing visits, physical therapy, and medical equipment — if a doctor orders them and you are homebound.

What Part B covers and what you pay

Part B covers doctor office visits, whether your doctor is in a hospital, clinic, or private practice. It pays for the doctor's time and the basic services in that visit — blood pressure checks, physical exams, routine tests. Part B also covers outpatient hospital services: emergency room visits, same-day surgery, lab work, and imaging like X-rays or ultrasounds when you do not stay overnight.

The Part B deductible for 2024 is $240 per year. After you meet this deductible, Part B pays 80 percent of the cost of most services, and you pay 20 percent. For example, if a doctor visit costs $100 and you have met your deductible, Medicare pays $80 and you pay $20. Some preventive services — annual wellness visits, cancer screenings, vaccines — have no copay or coinsurance after you meet the deductible.

Part B also covers durable medical equipment like wheelchairs, walkers, oxygen, and diabetic supplies. It covers mental health visits, physical therapy, and occupational therapy. It does not cover dental care, vision exams, hearing aids, or most prescription drugs — those require separate coverage.

How Part A and Part B work together

The two parts cover different settings and different types of care, so you often use both in a single episode of illness. If you have a heart attack, Part A covers your hospital stay. Part B covers the cardiologist's visit while you are in the hospital and the follow-up office visit after you go home. If you need rehabilitation after surgery, Part A covers the skilled nursing facility stay, and Part B covers the physical therapist's services during that stay.

Each part has its own deductible, so you may owe two deductibles in the same year if you use both parts. Each part also has its own rules about what you pay after the deductible. Understanding which part covers which service matters because it changes what you owe. A service covered by Part A might be free after the deductible, while the same type of service covered by Part B costs you 20 percent.

When you enroll in Part A and Part B

You become may be able to access for Medicare when you turn 65. Your initial enrollment window opens three months before the month you turn 65 and closes three months after. If you enroll during this window, your coverage starts on the first day of the month you turn 65. If you miss this window, you can enroll during the General Enrollment Period from January 1 through March 31 each year, but your coverage does not start until July 1 of that year, and you may owe a permanent penalty on your Part B premium.

You do not have to do anything if you are already receiving Social Security benefits — Medicare will enroll you automatically in Part A and Part B about three months before you turn 65. If you are not yet receiving Social Security, you must contact Social Security or visit Medicare.gov to enroll. If you are still working and have health insurance through your employer, you may be able to delay Part B enrollment without penalty, but you should contact Medicare to confirm your situation.

Costs beyond Part A and Part B

Part A and Part B do not cover everything. You are responsible for costs that exceed what each part covers — for example, if you stay in the hospital beyond 90 days, you pay all costs after your lifetime reserve days are used. Neither part covers dental work, vision care, hearing aids, or most prescription drugs. Neither part covers long-term care in a nursing home if you do not need skilled nursing care — that is custodial care, which Medicare does not pay for.

Many people buy Medigap (supplemental insurance) to cover the deductibles, copays, and coinsurance that Part A and Part B do not pay. Others choose Medicare Advantage (Part C), which is an alternative way to get Part A and Part B coverage through a private insurance company. Some people also buy a separate policy for prescription drug coverage (Part D). Understanding what Part A and Part B do and do not cover helps you decide whether you need additional coverage.

Frequently Asked Questions

Do I have to take both Part A and Part B?

Most people enroll in both, but you can decline Part B if you have other health insurance through an employer or union. If you decline Part B and later want it, you may owe a permanent penalty unless you have a may have access to reason for the delay. Part A is usually automatic if you are receiving Social Security.

What happens if I miss my enrollment window?

You can enroll during the General Enrollment Period from January through March, but coverage does not start until July 1. You will also owe a permanent 10 percent penalty on your Part B premium for each year you were may be able to access but not enrolled. The penalty stays on your premium for life.

Does Part B cover my doctor's full charge?

Part B pays 80 percent of the Medicare-approved amount, and you pay 20 percent. If your doctor does not accept Medicare assignment, you may owe more. Ask your doctor whether they accept Medicare assignment before your visit.

Can I use Part A and Part B at any hospital or doctor's office?

Part A and Part B work at any hospital or doctor that accepts Medicare, which is most of them. Some doctors and hospitals do not accept Medicare, so confirm before your visit. If you use an out-of-network provider, you may owe more.

What is a benefit period for Part A?

A benefit period begins the day you enter a hospital and ends 60 days after you leave. If you are readmitted after 60 days, a new benefit period starts and your deductible resets. This matters because your out-of-pocket costs depend on which benefit period you are in.