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Medicare Part A and Part B – What’s the Difference?

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When you qualify for Medicare, it’s usually Medicare Part A and Part B that you’re first enrolled in. Medicare Part A and Part B make up Original Medicare. This article explores the differences between the two parts of Medicare.

What is Medicare Part A?

Medicare Part A is hospital insurance. Part A generally covers inpatient hospital stays, skilled nursing care, hospice care, and limited home health-care services. You typically pay a deductible and coinsurance and/or copayments.

Do you have to pay a Part A premium?

Many people don’t pay a monthly premium for Medicare Part A. For example, if you worked at least ten years (40 quarters) while paying taxes, you don’t pay a premium for Part A. If you worked for fewer than 30 quarters, you generally pay $437 per month in 2019. If you worked more than 30 but fewer than 40 quarters, your premium is $240 per month in 2019.

What is Medicare Part B?

Medicare Part B is medical insurance. It generally covers services and items such as:

  • Doctor office visits
  • Preventive services such as certain tests and screenings
  • Flu shots
  • Pneumococcal shots
  • Mental health care (outpatient)
  • Alcohol use counseling
  • Chemotherapy
  • Physical therapy
  • Diabetes screenings, supplies, and self-management therapy
  • Durable medical equipment, such as wheelchairs

This is not a complete list. Part B may cover many different services and items, but certain coverage rules apply. For example, providers must accept Medicare assignment (a payment agreement with Medicare), and certain items and services must be medically necessary.

Under Part B, in most cases you will pay 20% of the Medicare-approved amount for each item or service. A deductible may apply.

Do you have to pay a Part B premium?

Your Part B premium may be the “standard” amount, $135.50 in 2019.

If your income is above a certain amount (based on your income tax returns from two years ago), you might pay a higher Part B premium.

Can you ever get both Part A and Part B coverage at the same time?

When you’re an inpatient in a hospital, it’s possible to get Part A and Part B coverage at the same time. For example, while Part A generally covers medically necessary surgery and certain hospital costs, Part B may cover doctor visits while you’re an inpatient.

Did you know that there’s another way to get your Part A and Part B coverage? A Medicare Advantage plan delivers these benefits, and often more. Most Medicare Advantage plans include prescription drug coverage. Learn more about Medicare Advantage plans. You must pay your Medicare Part B premium when you have a Medicare Advantage plan, as well as any premium the plan might charge.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/co-insurance may change on January 1 of each year.

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