What Is the Difference Between Medicare Part A and Part B?
Last Updated : 06/11/20195 min read
“Medicare Part A and Part B” – you may have heard about these “parts” of Medicare. But what are Medicare Part A and Part B? Here’s a quick and clear summary of what Medicare Part A and Part B are.
Part A and Part B
Medicare Part A and Part B make up the federal program known as Original Medicare. Learn more about how you qualify for Medicare.
- If you’re eligible for Medicare Part A and Part B, you might be enrolled automatically.
- If you’re getting Social Security (or Railroad Retirement Board) benefits when you turn 65, you’re typically enrolled without having to do anything.
- If you’re under 65 and get disability benefits, you may be enrolled in Medicare Part A and Part B automatically. Read the details of when you’ll get enrolled in Part A and Part B if you qualify for Medicare due to disability.
Be aware, though, that sometimes you’re not automatically enrolled, and you have to take steps to enroll in Medicare. For example:
- If you have end-stage renal disease (ESRD), you might qualify for Medicare before you’re 65, but you have to sign up through Social Security.
- If you live in Puerto Rico, even if you’re automatically enrolled in Medicare Part A, you need to enroll manually in Medicare Part B.
- If you delayed enrollment in Medicare Part A and/or Part B beyond your Medicare Initial Enrollment Period, you need to enroll manually.
This might not be a complete list of occasions when you have to enroll manually.
What is Medicare Part A?
Medicare Part A is hospital insurance. It may cover your care in certain situations, such as:
- You’re admitted to a hospital or mental hospital as an inpatient.
- You’re admitted to a skilled nursing facility and meet certain conditions.
- You qualify for hospice care.
- Your doctor orders home health care for you and you meet the Medicare criteria. Medicare Part A may cover part-time home health care for a limited time.
Even when Medicare Part A covers your care:
- You may have to pay a deductible amount and/or coinsurance or copayment.
- There may be some services you get in a hospital or other setting that Medicare doesn’t cover.
- It’s possible that your Part A coverage will run out – for example, if you stay in the hospital for more than 90 days in a row, you might have to pay all costs. Learn more about Medicare Part A
- Medicare typically won’t pay for a private room or non-medical items such as toiletries (like a razor) or a television in your room.
What is Medicare Part B?
Medicare Part B is medical insurance. It may cover a wide range of items and services. Here’s a partial list of what Part B may cover:
- Doctor visits
- Preventive services, like annual checkups and flu shots
- Medical supplies and durable medical equipment, such as walkers and wheelchairs
- Certain lab tests and screenings
- Diabetes care, such as screenings, supplies, and a prevention program
- Physical and occupational therapy
A Part B deductible and/or coinsurance or copayments may apply.
What do Medicare Part A and Part B have in common?
Medicare Part A and Part B share some characteristics, such as:
- Both are parts of the government-run Original Medicare program.
- Both may cover different hospital services and items.
- Both may cover mental health care (Part A may cover inpatient care, and Part B may cover outpatient services).
- Both may cover home health care.
- Both have annual deductibles, as well as coinsurance or copayments, that may apply to certain services.
- Both have monthly premiums, although many people don’t have to pay the Part A premium (see below).
How are Medicare Part A and Part B different?
Although both Medicare Part A and Part B have monthly premiums, whether you’re likely to pay a premium – and how much – depends on the “part” of Medicare.
Most people don’t have to pay a monthly premium for Medicare Part A.
- If you’ve worked and paid Medicare taxes for at least 10 years (40 quarters), you typically don’t pay a premium.
- If you worked 30-39 quarters, you’ll generally pay $240 in 2019.
- If you worked fewer than 30 quarters, you’ll generally pay $437 in 2019.
On the other hand, most people do pay a monthly premium for Medicare Part B. The standard premium in 2019 is $135.50, but you may pay more if your income is above a certain level. If you have a low income or no income, in some cases Medicaid might pay your Part B premium.
Can you get insurance to help cover Part A and Part B expenses?
As you’ve seen in this article, Medicare Part A and Part B generally come with out-of-pocket costs for you to pay. Did you know that you might be able to buy a Medicare Supplement insurance plan to help cover those expenses? There are up to 10 standardized Medicare Supplement plans available in most states. Learn more about Medicare Supplement insurance.
You can compare Medicare Supplement plans and Medicare coverage options anytime you like, with no obligation. Type your zip code in the box on this page to begin.
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