Medicare Part A covers hospital stays, skilled nursing, and hospice
Medicare Part A is hospital insurance. It pays for inpatient hospital care, stays in a skilled nursing facility after a hospital stay, hospice care, and some home health services. You do not pay a monthly premium for Part A if you or your spouse paid Medicare taxes while working — it is included in what you have already paid into the system.
Part A has a deductible you pay once per benefit period (a new benefit period starts 60 days after you leave the hospital). In 2024, that deductible is $1,696 for an inpatient hospital stay. After you meet the deductible, Medicare covers all costs for the first 60 days. Days 61 through 90 require a daily coinsurance amount — in 2024, that is $424 per day. If you stay longer than 90 days, you can use lifetime reserve days, which also have a daily cost.
Part A does not cover custodial care (help with bathing, dressing, or daily living) unless it is part of skilled nursing care you need after a hospital stay. It also does not cover private rooms, television, or phone charges unless medically necessary.
Medicare Part B covers doctor visits, outpatient care, and medical equipment
Medicare Part B is medical insurance. It pays for doctor visits, outpatient hospital services, diagnostic tests, physical therapy, mental health services, and durable medical equipment like wheelchairs and oxygen. Unlike Part A, Part B requires a monthly premium, which changes each year based on your income. In 2024, the standard premium is $164.90 per month, though higher earners pay more.
Part B also has an annual deductible — $240 in 2024 — that you pay once per calendar year before Medicare starts paying. After you meet the deductible, Medicare typically covers 80 percent of the cost of covered services, and you pay the remaining 20 percent as coinsurance. This means your out-of-pocket costs can add up quickly if you have frequent doctor visits or need expensive treatments.
Part B does not cover routine dental care, vision exams for glasses or contacts, hearing aids, or long-term custodial care. It also does not cover services you receive outside the United States, except in very limited circumstances.
Key Takeaways
- Part A covers hospital stays and skilled nursing care after hospitalization, with no monthly premium if you paid Medicare taxes while working.
- Part B covers doctor visits, outpatient services, and medical equipment, and requires a monthly premium that varies by income.
- Both Part A and Part B have annual or per-stay deductibles you must pay before Medicare coverage begins.
- After the deductible, you typically pay coinsurance (a percentage of the cost) for Part A hospital stays beyond 60 days and for all Part B services.
- Neither Part A nor Part B covers routine dental, vision, hearing aids, or long-term custodial care at home.
How Part A and Part B work together
Part A and Part B are designed to work as a pair. Part A covers the hospital building and facility costs; Part B covers the doctors and services inside that hospital. If you are admitted to the hospital, Part A pays the facility costs after you meet the deductible, and Part B pays for your doctor's services and any outpatient tests or treatments you receive while there.
When you turn 65, you become may be able to access for both parts. Part A enrollment is automatic if you are receiving Social Security benefits. Part B enrollment is not automatic — you must sign up 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 delay enrolling in Part B without good reason, you may face a permanent penalty on your monthly premium.
What you pay out of pocket with Part A and Part B
Your total out-of-pocket costs depend on how much medical care you use. With Part A, your main costs are the deductible per benefit period and daily coinsurance if you stay in the hospital longer than 60 days. With Part B, you pay the monthly premium, the annual deductible, and then 20 percent coinsurance for most services.
Many people buy Medigap (supplemental insurance) or enroll in Medicare Advantage (Part C) to reduce these out-of-pocket costs. Medigap helps pay the deductibles and coinsurance you would otherwise owe under Part A and Part B. Medicare Advantage is an alternative way to receive Part A and Part B benefits through a private insurance company, often with lower out-of-pocket costs but a smaller network of doctors.
Part A and Part B do not cover everything
Even with both parts, significant gaps remain. Prescription drugs are not covered by Part A or Part B — you need Part D (prescription drug coverage) for that. Dental care, vision care, and hearing aids are not covered by either part. Long-term care in a nursing home or at home is not covered unless it is skilled nursing care when ready following a hospital stay.
If you need services not covered by Part A and Part B, you pay the full cost yourself, unless you have supplemental coverage like Medigap or are enrolled in a Medicare Advantage plan that includes those benefits. This is why understanding what each part covers — and what it does not — matters before you enroll.
Frequently Asked Questions
Do I have to take both Part A and Part B?
Part A is automatic at 65 if you receive Social Security. Part B is optional, but if you do not sign up when you are first may be able to access, you may pay a permanent penalty. If you are still working and have employer health insurance, you may be able to delay Part B without penalty, but you must tell Social Security.
What happens if I stay in the hospital longer than 90 days?
Part A covers up to 90 days per benefit period, plus 60 lifetime reserve days you can use if needed. After those are exhausted, you pay all costs. A new benefit period begins 60 days after you leave the hospital, which resets your coverage.
Why do I pay 20 percent coinsurance with Part B if Medicare covers 80 percent?
Part B is designed to share the cost between Medicare and you. The 20 percent you pay is meant to discourage overuse of services. If you have Medigap or Medicare Advantage, those plans may cover some or all of that 20 percent coinsurance.
Can I use Part A and Part B outside the United States?
Part A and Part B generally do not cover care outside the U.S., with rare exceptions for emergency care in Canada or Mexico near the border. If you travel internationally, you may want to purchase travel health insurance or enroll in a Medicare Advantage plan that covers foreign travel.