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Medicare Part A and Part B

Medicare Part A and Part B is the insurance program offered by the federal government.

Sometimes referred to as "Original Medicare," Medicare Part A and Part B provides eligible individuals with coverage at the hospital and doctor’s office. To be eligible, you must be 65 years of age or older, or you may also qualify if you are under 65 and have a disability. You can enroll in Medicare Part A and Part B through the government or by visiting, which is the federal government’s social security website.

Medicare Part A and Part B benefits are comprised of two parts: 1) Medicare Part A, which is for hospital coverage, and 2) Medicare Part B, which includes doctor visits, mental health services, and ambulance services, among other kinds of coverage.

Medicare Part A: Coverage and Costs

Medicare Part A covers inpatient hospital care, limited home health services, limited skilled nursing care facility services, and hospice care.

Inpatient Hospital Care

Inpatient hospital care includes coverage for a room, nursing services, medications, medical supplies, and meals that are necessary for your treatment. You can receive inpatient hospital care at the following types of facilities:

  • Emergency or Critical Care.
  • Mental Health.
  • Rehabilitation.
  • Long Term Care.

Home Health Services

If your doctor has ordered home health care, and it is medically necessary, the following expenses should be covered by Medicare Part A:

  • Skilled nursing care (part-time or intermittent).
  • Physical therapy.
  • Occupational therapy.
  • Speech pathology.
  • Medical social services.
  • Durable medical equipment (80% of cost).

You will not be covered for 24-hour home health care unless it is medically necessary.

Skilled Nursing Facility Care

If your doctor recommends you transfer from inpatient hospital care to a Medicare-certified skilled nursing facility, Medicare Part A should cover the following expenses:

  • Semi-private room.
  • Skilled nursing services.
  • Rehabilitation services.
  • Medications while in the care of the skilled nursing facility.
  • Medical supplies and equipment while in the care of the skilled nursing facility.
  • Meals and dietary counseling.
  • Medical social services.

Long-term medical or personal care is not covered if that is the only type of care you need.

Hospice Care

If you have been diagnosed with a terminal illness, you may be eligible for hospice care, which will usually be provided in your home. To be eligible you must be (1) enrolled in Medicare Part A, (2) have been diagnosed by a doctor with a terminal illness with six months or less to live, and (3) agree to no longer receive medical treatment for your terminal illness.

The hospice care must be provided by a Medicare-approved hospice care provider and may include coverage for:

  • Doctor services.
  • Nursing care.
  • Social services.
  • Medical supplies.
  • Pain relief medications.
  • Homemaker services.
  • Hospice aide services.
  • Physical and occupational therapy.
  • Dietician services.
  • Short-term inpatient hospital care, as medically necessary.

You have the right to discontinue hospice care if you decide to seek additional treatment for a terminal illness at any time.

Medicare Part B: Coverage and Costs

Medicare Part B covers visits to your doctor, preventative health screenings, blood tests, medical equipment and supplies, outpatient hospital care, and more.

You will pay a monthly premium for Part B benefits, as well as a small annual deductible and coinsurance (usually 20%).

Medicare Part B monthly premiums are based on income. Generally speaking, the higher your income, the higher your premium. The income tiers are as follows:

Beneficiaries who file individual tax returns with modified adjusted gross income:

Beneficiaries who file joint tax returns with modified adjusted gross income:

Income-Related Monthly Adjustment Amount

Total Monthly Premium Amount

Less than or equal to $97,000

Less than or equal to $194,000



Greater than $97,000 and less than or equal to $123,000

Greater than $194,000 and less than or equal to $246,000



Greater than $123,000 and less than or equal to $153,000

Greater than $246,000 and less than or equal to $306,000



Greater than $153,000 and less than or equal to $183,000

Greater than $306,000 and less than or equal to $366,000



Greater than $183,000 and less than $500,000

Greater than $366,000 and less than $750,000



Greater than or equal to $500,000

Greater than or equal to $750,000



Please note that if you are already receiving Social Security or Railroad Retirement Board benefits, your monthly premium will automatically be deducted from these payments once you are enrolled in Medicare Part A and Medicare Part B.

Gaps in Medicare Part A and Part B Coverage

Due to the lack of maximum out-of-pocket limits as well as the Part B coinsurance, many people seek to close the "gap" in Medicare Part A and Part B coverage with Private Medicare Insurance.

Additionally, Medicare Part A and Part B does not cover the following:

  • Prescription drugs (unless hospitalized).
  • Most dental care and dentures.
  • Eye exams and contacts/eyeglasses.
  • Hearing aids and exams.
  • Long-term care.
  • Foreign travel health care.

To cover the items that Medicare Part A and Part B does not cover, in addition to getting help for out-of-pocket costs, many people opt to purchase a Medigap, Medicare Advantage, or a Part D plan.

To get additional Medicare coverage, please submit your zip code to begin the process.

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Federal Contracting Statement: Plans are insured or covered by a Medicare Advantage organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare.

We do not offer every plan available in your area. Currently we represent zero organizations which offer zero products in your area. Please contact, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. We connect you with licensed agents that do have Medicare Advantage Plans and they will tell you how many plans and products they offer in your service area.

This website may not display all data on Qualified Health Plans being offered in your state through the Marketplace website or the federal Medicare program. This is not a complete listing of plans available in your service area. To see all available data on Qualified Health Plan options in your state, visit your state Marketplace website, go to the Health Insurance Marketplace website at or consult

Submitting this form does NOT affect your current enrollment, nor will it enroll you in a Medicare Advantage plan, Medicare Prescription Drug plan, Medicare Supplement Plan, or any other Medicare plan. QuoteLab, LLC is independent of the Medicare program and is neither associated with nor endorsed by The Centers for Medicare & Medicaid Services (CMS) or any other governmental agency.

The plans represented on are Medicare Advantage HMO, PPO and PFFS organizations and stand-alone prescription drug plans with a Medicare contract. Enrollment in any plan depends on contract renewal. If you are paying Medicare Part B premium, you must continue to pay it to maintain coverage.

Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

Every year, Medicare evaluates plans based on a 5-star rating system.

Part B Premium give-back is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.

Based on median Medicare Advantage benefit amounts for dental available across multiple plans and metro areas. Not all benefits available in specific plans or regions.

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/coinsurance] may change on January 1 of each year.

Advertised Pricing:

There are several factors that impact your monthly premium; including your age, geographical location, annual income, dependents, and the type of plan you choose. Monthly premiums do not include out-of-pocket costs.

The advertised price may not be typical. It was generated using the Kaiser Family Foundation's subsidy calculator that was accessed on September 16, 2020. The following parameters were used: 21 year old adult, non-tobacco user, annual income of $24,700 in 2020, no children, and no available coverage through a spouse's employer. The resulting monthly premium was $30 per month (or $360 per year after $2,751 in subsidies) for a Bronze Plan. Even when using the same parameters, the resulting premium and subsidy calculations may be subject to change.