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 that changes each year. After three days, you pay a daily coinsurance amount for days 4 through 60, and a higher daily amount for days 61 through 90. If you stay longer than 90 days, you can use "lifetime reserve days" — a fixed number of extra days Medicare will cover at a higher cost to you, but only once in your lifetime.
In a skilled nursing facility (not a regular nursing home), Part A covers up to 100 days per benefit period if you were hospitalized first for at least three consecutive days. You pay nothing for days 1 through 20, and a daily coinsurance for days 21 through 100. After 100 days, you pay the full cost yourself.
Part A also covers hospice care for people with a terminal illness, and some home health visits if a doctor orders them and you meet specific conditions — mainly that you are homebound and need skilled care like wound dressing or physical therapy, not just help with daily tasks.
Medicare Part B covers doctor visits, outpatient care, tests, and some equipment
Medicare Part B is medical insurance for everything that is not a hospital stay. It covers visits to doctors and specialists, lab tests, X-rays, outpatient surgery, emergency room visits, and some medical equipment like wheelchairs and oxygen. You pay a monthly premium for Part B, and the amount depends on your income.
Part B also covers preventive care at no cost to you — annual wellness visits, cancer screenings, vaccines, and heart disease and diabetes screenings. You pay nothing for these services, even before you meet your deductible.
For other Part B services, you pay an annual deductible first, then Medicare pays 80 percent and you pay 20 percent coinsurance. This means your costs can add up quickly if you have many doctor visits or expensive tests. There is no yearly cap on what you pay out of pocket for Part B services.
Part B does not cover routine dental, vision, or hearing care. It also does not cover long-term care in a nursing home, custodial care (help with bathing or dressing), or most prescription drugs — those are covered under Part D, a separate plan you choose.
Key Takeaways
- Part A covers hospital stays, skilled nursing facilities, hospice, and some home health care; Part B covers doctor visits, outpatient care, tests, and preventive screenings.
- Part A has no monthly premium if you paid Medicare taxes for 10 years, but Part B requires a monthly premium based on your income.
- Both parts require you to pay deductibles and coinsurance, meaning Medicare does not cover 100 percent of your costs.
- Part A and Part B do not cover dental, vision, hearing care, prescription drugs, or long-term custodial nursing home care.
- Preventive services under Part B — like annual wellness visits and cancer screenings — are covered at no cost to you.
What you pay out of pocket under Part A and Part B
Medicare Part A and Part B both require you to pay money before and after Medicare starts paying. Understanding these costs helps you plan for medical expenses.
For Part A, you pay a deductible per benefit period — a benefit period starts when you enter a hospital and ends after you have been out for 60 consecutive days. In 2024, that deductible is $1,676, but this amount changes yearly. If you are hospitalized twice in the same year with more than 60 days between stays, you pay the deductible twice.
For Part B, you pay a monthly premium (the amount varies by income), an annual deductible (in 2024, $240), and then 20 percent coinsurance on most services after the deductible is met. Some services, like mental health visits, may have different coinsurance amounts. Preventive care has no deductible or coinsurance.
Neither Part A nor Part B has a yearly out-of-pocket maximum, which means your costs can be very high if you have serious illness or injury. Many people buy supplemental insurance (called Medigap) or choose Medicare Advantage plans to limit their costs.
Services Part A and Part B do not cover
Part A and Part B leave significant gaps. They do not cover prescription drugs — you need Part D for that. They do not cover dental work, eyeglasses, hearing aids, or routine vision and hearing exams. Dentures, dental implants, and most dental procedures are not covered at all.
Part A does not cover custodial care in a nursing home — the help with bathing, dressing, eating, and toileting that many people need as they age. It only covers skilled nursing care, which is medical care like wound care or physical therapy ordered by a doctor. If you need a nursing home for custodial care, you pay the full cost yourself unless you have Medicaid or private long-term care insurance.
Neither part covers routine foot care, most acupuncture, or cosmetic surgery. They also do not cover care you receive outside the United States, except in very limited situations near the border.
How Part A and Part B work together
Part A and Part B are designed to work as a pair, but they cover different settings. Part A pays for hospital stays; Part B pays for the doctors who treat you in that hospital. Part A pays for a skilled nursing facility stay after hospitalization; Part B pays for the doctor visits and tests you receive there.
When you are admitted to a hospital, Part A covers your room, meals, nursing care, and basic hospital services. Part B covers the surgeon, radiologist, pathologist, and other doctors who provide care during your stay. You may receive bills from both programs.
If you receive care in an outpatient setting — a doctor's office, urgent care center, or hospital outpatient department — Part B covers it, not Part A. Part A only covers inpatient care, meaning you stay overnight in a hospital bed.
Medigap and Medicare Advantage as alternatives to Part A and Part B alone
Because Part A and Part B leave you paying deductibles, coinsurance, and uncovered services, many people buy additional coverage. Medigap (supplemental insurance) works alongside Original Medicare — you keep Part A and Part B and buy a Medigap plan from a private insurer to cover some or all of the costs Medicare does not pay.
Different Medigap plans cover different things. Some cover your Part A deductible, some cover coinsurance, some cover foreign travel. You pay a monthly premium for Medigap on top of your Part B premium. The best time to buy Medigap is within six months of turning 65, because insurers cannot deny you or charge more based on health conditions during that window.
Medicare Advantage is a different route. Instead of Original Medicare (Part A and Part B) plus Medigap, you can choose a Medicare Advantage plan, which is a private insurance plan that covers everything Part A and Part B cover, usually with lower out-of-pocket costs and sometimes dental or vision benefits. However, Medicare Advantage plans have networks — you must use doctors and hospitals in the plan's network, and you may need referrals to see specialists. Plans vary widely by region and by year.
Frequently Asked Questions
Does Medicare Part A or Part B cover prescription drugs?
No. Prescription drug coverage is Part D, a separate plan you choose and pay for. You can add Part D to Original Medicare, or it is usually included in Medicare Advantage plans. If you do not sign up for Part D when you first become may be able to access, you may pay a penalty if you sign up later.
What happens if I stay in the hospital longer than 90 days?
Part A covers up to 90 days per benefit period, plus a limited number of "lifetime reserve days" — extra days you can use only once in your lifetime. After those are exhausted, you pay the full hospital cost. A benefit period ends 60 days after you leave the hospital, so a new benefit period (and new deductible) begins if you are readmitted.
Do I have to buy Part B if I have Part A?
Part A and Part B are separate. You can have Part A without Part B, but most people need both because Part A only covers hospital and skilled nursing stays. If you delay Part B after age 65, you may pay a penalty for the rest of your life. Talk to Medicare before declining Part B.
Does Part A cover a regular nursing home?
Part A covers a skilled nursing facility for up to 100 days after a hospital stay, but only if the care is skilled — like physical therapy or wound care ordered by a doctor. It does not cover a regular nursing home where you receive custodial care (help with daily tasks). You pay for custodial nursing home care yourself unless you have Medicaid or private long-term care insurance.
Can I use Part A and Part B outside the United States?
Generally, no. Medicare does not cover care outside the U.S. except in rare cases near the border (Canada and Mexico) or on a cruise ship within U.S. territorial waters. If you travel internationally, you may want to buy a travel insurance plan that covers medical care abroad.