Medicare Part A covers hospital stays, skilled nursing, hospice, and some home health care
Medicare Part A is hospital insurance. It pays for inpatient hospital care — meaning you stay overnight — plus skilled nursing facilities, hospice care, and limited home health services. 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 A covers the full cost of the first three days in a hospital, minus a deductible you pay upfront (the amount changes yearly). After three days, you pay a daily coinsurance amount for days 4 through 60. Days 61 and beyond cost more per day, and after 90 days in a single hospital stay, Part A stops paying. If you need a skilled nursing facility after a hospital stay — not a regular nursing home, but one providing medical care like wound treatment or physical therapy — Part A covers the first 20 days fully, then charges you a daily coinsurance for days 21 through 100.
Part A also covers hospice care when a doctor says you have six months or less to live, and it covers some home health visits if you are homebound and a doctor orders the care. Home health coverage is limited: Part A pays only if a skilled nurse or therapist is providing the service, not for general help around the house.
Medicare Part B covers doctor visits, outpatient care, tests, and preventive services
Medicare Part B is medical insurance. It covers doctor office visits, emergency room visits, outpatient surgery, lab tests, X-rays, imaging like MRI or CT scans, and preventive care such as cancer screenings and annual wellness visits. You pay a monthly premium for Part B (the amount depends on your income), plus you pay 20 percent of the cost after you meet your yearly deductible.
Part B covers most preventive services at no cost to you — things like mammograms, colonoscopies, blood pressure checks, and diabetes screenings — as long as you see a doctor who accepts Medicare. If your doctor does not accept Medicare assignment, you may pay more out of pocket.
Part B does not cover routine dental care, vision exams, hearing aids, or prescription drugs. It also does not cover long-term custodial care in a nursing home — the kind where staff help you bathe and dress but no skilled medical care is happening. That is a major gap many people do not realize until they need it.
Key Takeaways
- Part A pays for hospital stays, skilled nursing facilities after hospitalization, hospice, and some home health care, with no monthly premium if you worked and paid taxes for 10 years.
- Part B pays for doctor visits, outpatient procedures, lab tests, imaging, and preventive screenings, but requires a monthly premium and you pay 20 percent of costs after your deductible.
- Neither Part A nor Part B covers routine dental, vision, hearing aids, prescription drugs, or long-term custodial nursing home care.
- Part A hospital coverage ends after 90 days in a single stay, and skilled nursing coverage ends after 100 days, so very long hospitalizations can leave you paying out of pocket.
- Preventive services under Part B are free when you use a Medicare-accepting doctor, but costs rise sharply if your doctor does not accept Medicare assignment.
What happens when Part A and Part B coverage ends
Once Part A stops paying — after 90 hospital days or 100 skilled nursing days in a single spell of illness — you are responsible for all remaining costs. This is why many people buy supplemental insurance (called Medigap) or join a Medicare Advantage plan: to cover the gaps Part A and Part B leave behind.
For Part B, the 20 percent coinsurance you pay can add up quickly if you need frequent doctor visits or expensive tests. If you see a doctor who does not accept Medicare, your costs are even higher because you may have to pay the full bill upfront and then request reimbursement yourself — and Medicare will only reimburse what it considers reasonable, which is often less than what the doctor charged.
The difference between Part A deductibles and Part B deductibles
Part A has one deductible per benefit period. A benefit period starts when you enter the hospital and ends 60 days after you leave. If you go back into the hospital within 60 days, you do not pay a new deductible — you are still in the same benefit period. If you stay out for 60 days and then return, a new benefit period begins and you pay the deductible again.
Part B has a yearly deductible that resets on January 1 each year. Once you meet it, you pay 20 percent of the Medicare-approved amount for the rest of the year. The deductible amounts change yearly and are set by Medicare, so check your Medicare statements each January to see what your new deductible is.
How to know if a service is covered before you go
The safest step is to call Medicare directly at 1-800-MEDICARE before you schedule a procedure or see a new doctor. Have your Medicare card ready and tell them exactly what service you need. They can tell you whether it is covered, what you will pay, and whether the doctor or facility accepts Medicare.
You can also ask your doctor's office directly — they usually know what Medicare covers and what your share will be. If they are unsure, ask them to contact Medicare on your behalf. Do not assume a service is covered just because your doctor recommends it; some treatments are not covered by Medicare even if they are medically necessary.
Prescription drugs are not covered by Part A or Part B
If you take prescription medications, Part A and Part B do not pay for them. You need Medicare Part D (prescription drug coverage) to help with medication costs. Part D is optional, but if you do not sign up when you first become may be able to access, you may pay a penalty for the rest of your life. Part D plans vary widely in which drugs they cover and how much you pay, so comparing plans each year during open enrollment is important.
Some people get prescription coverage through a Medicare Advantage plan instead of Part D, so if you join an Advantage plan, check whether it includes drug coverage before you sign up.
Frequently Asked Questions
Does Part A or Part B cover nursing home care?
Part A covers skilled nursing facilities for up to 100 days after a hospital stay, but only if you are receiving skilled medical care like wound dressing or physical therapy. Regular nursing home care where staff help you with daily activities but no skilled nursing is involved is not covered by either Part A or Part B. You pay for that out of pocket or through Medicaid if you meet income limits.
What if my doctor does not accept Medicare?
You can still see them, but you will likely pay more. If they do not accept Medicare assignment, you may have to pay the full bill upfront and then request reimbursement from Medicare yourself. Medicare will only reimburse what it considers reasonable, which is often less than the doctor's actual charge, leaving you to pay the difference.
Do I have to pay anything for preventive care under Part B?
No — preventive services like cancer screenings, blood pressure checks, and wellness visits are free under Part B when you see a doctor who accepts Medicare. However, if the visit turns into treatment for a problem, you will pay your 20 percent coinsurance on the treatment portion.
What is the difference between Part A and Part B deductibles?
Part A has one deductible per benefit period (which resets 60 days after you leave the hospital). Part B has a yearly deductible that resets January 1. Once you meet your Part B deductible, you pay 20 percent of covered services for the rest of the year.
Can I use Part A and Part B at any hospital or doctor?
Part A works at any hospital that accepts Medicare, which is nearly all of them. Part B works with any doctor who accepts Medicare, but not all do. Before scheduling, confirm that your doctor accepts Medicare to avoid surprise bills.