Medicare Part A vs Part B differences explained for 2026

Medicare Part A vs Part B: What’s the Difference in 2026?

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You’ve heard of Medicare Part A and Part B. But what’s the difference? Which one do you need? Do you need both?

The simple version: Part A covers hospital care. Part B covers doctor visits. You need both. Most people get Part A for free and pay $202.90 per month for Part B.

This guide explains everything about both parts in plain language so you know exactly what you’re getting.

The Quick Answer

Medicare Part A = Hospital Insurance Covers you when you’re admitted to a hospital, skilled nursing facility, or hospice. Also covers some home health care.

Medicare Part B = Medical Insurance Covers you when you visit the doctor, get lab work, need outpatient procedures, or use preventive services.

Think of it this way:

  • Part A = inside the hospital
  • Part B = outside the hospital

You need both parts to have complete Original Medicare coverage.

What Does Part A Cover?

Medicare Part A covers four main things:

1. Hospital Stays

When you’re admitted to a hospital as an inpatient, Part A covers:

  • Your hospital room
  • Meals
  • Nursing care
  • Medications given during your stay
  • Lab tests and X-rays during your stay
  • Surgery performed during your stay
  • Intensive care (ICU)

2. Skilled Nursing Facility Care

If you need short-term skilled care after a qualifying hospital stay, Part A covers:

  • A semi-private room
  • Meals
  • Skilled nursing care
  • Physical therapy and occupational therapy
  • Medications and medical supplies

Important: Part A only covers up to 100 days in a skilled nursing facility. And you must have a qualifying 3-day hospital stay first. It does NOT cover long-term nursing home care.

3. Hospice Care

If you have a terminal illness and choose comfort care instead of treatment, Part A covers hospice services:

  • Pain management and symptom control
  • Nursing visits
  • Counseling
  • Medications related to your terminal condition
  • Medical equipment
  • Short-term respite care for your caregiver

Hospice care costs you $0 for most services.

4. Home Health Care

Part A covers home health care when you’re homebound and need skilled medical care at home. This includes nursing, physical therapy, and other services.

Home health care costs you $0. No copay, no deductible. It’s one of Medicare’s best benefits.

What Does Part A Cost?

Monthly Premium

Most people pay $0 per month for Part A. If you or your spouse worked and paid Medicare taxes for at least 10 years (40 quarters), Part A is free.

If you didn’t work long enough:

  • 30-39 quarters: $311 per month in 2026
  • Less than 30 quarters: $565 per month in 2026

Part A Deductible

You pay $1,736 per benefit period in 2026. This is the amount you pay before Part A starts covering your hospital stay.

What’s a benefit period? It starts when you enter the hospital. It ends when you haven’t received hospital or skilled nursing care for 60 days in a row. If you go back within 60 days, you’re in the same benefit period. If you go back after 60 days, a new benefit period starts and you pay the deductible again.

Hospital Stay Costs

  • Days 1-60: $0 per day (after the deductible)
  • Days 61-90: $434 per day
  • Days 91+: $868 per day (lifetime reserve days — you only get 60 total)

Skilled Nursing Facility Costs

  • Days 1-20: $0 per day
  • Days 21-100: $217 per day
  • After 100 days: Medicare stops paying

A Medigap plan covers the Part A deductible and the daily coinsurance. With Medigap Plan G, you pay $0 for hospital stays regardless of how long you’re there.

What Does Part B Cover?

Medicare Part B covers a much wider range of services than Part A. Here are the main categories:

Doctor Visits

  • Primary care visits
  • Specialist visits
  • Second opinions before surgery
  • Telehealth visits

Preventive Services (Many at $0)

  • Annual wellness visit — $0
  • Flu shots — $0
  • COVID vaccines — $0
  • Mammograms — $0
  • Colonoscopy screening — $0
  • Prostate screening — $0
  • Depression screening — $0
  • Diabetes screening — $0
  • Bone density test — $0
  • Cardiovascular screening — $0

Take advantage of these free preventive services. They catch problems early when they’re cheaper and easier to treat.

Outpatient Services

Medical Equipment

  • Wheelchairs
  • Walkers
  • Hospital beds for home use
  • Oxygen equipment
  • Blood sugar monitors
  • Nebulizers

Ambulance Services

Part B covers ambulance rides when medically necessary.

What Part B Does NOT Cover

What Does Part B Cost?

Monthly Premium

$202.90 per month in 2026 for most people. This comes out of your Social Security check automatically.

Higher-income people pay more (IRMAA):

  • Under $109,000 single / $218,000 married: $202.90
  • $109,000-$137,000 single: $284.10
  • $137,000-$171,000 single: $406.90
  • Over $500,000 single: $689.90

Part B Deductible

$283 per year. You pay this once per year before Part B starts covering its share.

Part B Coinsurance

After the deductible, you pay 20% of the Medicare-approved amount. Medicare pays 80%.

Critical: There is no cap on Part B coinsurance under Original Medicare. A $100,000 surgery means you owe $20,000 in coinsurance.

This is the #1 reason people buy Medigap. Plan G covers that 20% so you don’t face unlimited out-of-pocket costs.

Part A vs Part B: Side by Side

What does it cover?

  • Part A → Hospital stays, skilled nursing, hospice, home health
  • Part B → Doctor visits, outpatient care, preventive services, equipment

Monthly premium?

  • Part A → $0 for most people
  • Part B → $202.90/month

Annual deductible?

  • Part A → $1,736 per benefit period
  • Part B → $283 per year

Your share of costs?

  • Part A → $0 for first 60 days, then $434-$868/day
  • Part B → 20% of approved amount with no cap

Is it automatic?

  • Part A → Yes, if you’re receiving Social Security at 65
  • Part B → Yes, if you’re receiving Social Security at 65

Can you delay it?

  • Part A → Yes, but no reason to (it’s free)
  • Part B → Yes, if you have employer coverage (20+ employees)

Late penalty?

  • Part A → Rare (only if you pay a premium)
  • Part B → 10% increase for every year you delay — permanent

Do You Need Both?

Yes. Part A and Part B together make up Original Medicare. Without both, you have major gaps in coverage.

Part A without Part B: You’re covered in the hospital but NOT at the doctor. Every doctor visit, lab test, X-ray, and outpatient procedure comes out of your pocket.

Part B without Part A: You’re covered at the doctor but NOT in the hospital. One hospital stay could cost you tens of thousands of dollars.

Both together: You have comprehensive coverage for most medical situations. The main gaps are prescriptions (need Part D), dental, vision, and hearing.

What About Part C and Part D?

People get confused by all the “parts.” Here’s the complete picture:

Part A = Hospital insurance (covered above)

Part B = Medical insurance (covered above)

Part C = Medicare Advantage — private plans that bundle A, B, and usually D together. Replaces Original Medicare.

Part D = Prescription drug coverage — covers medications. You add this to Original Medicare.

Two ways to get coverage:

  1. Original Medicare (Part A + Part B) + Part D + optional Medigap — the traditional approach
  2. Medicare Advantage (Part C) — bundles everything into one plan

Both approaches are valid. Read our Medicare Advantage vs Medigap guide to decide which is right for you.

Frequently Asked Questions

Can I have Part A without Part B? Yes. Since Part A is free for most people, you can enroll in Part A only. But this leaves you without doctor visit coverage. Most people should enroll in both.

Why would someone skip Part B? Usually because they have employer health insurance that covers doctor visits. If your employer has 20+ employees and your coverage is creditable, you can delay Part B without penalty.

What if I only have Part B? This is rare and not recommended. Without Part A, you’d pay full price for any hospital stay. Since Part A is usually free, there’s no reason not to have it.

Does Part A cover emergency room visits? Only if you’re admitted to the hospital from the ER. If you visit the ER but are NOT admitted, Part B covers the ER visit (you pay 20% coinsurance).

Does Part B cover prescription drugs? Part B covers a small number of drugs given in a doctor’s office or hospital outpatient setting (like chemotherapy or certain injections). For pharmacy prescriptions, you need Part D.

When should I enroll in Part A and Part B? During your Initial Enrollment Period — the 7-month window around your 65th birthday. Sign up 3 months before you turn 65 for coverage starting on your birthday.

Can I switch between Original Medicare and Medicare Advantage? Yes. During Open Enrollment (October 15 to December 7), you can switch between Original Medicare and Medicare Advantage.

What to Do Right Now

  1. If you’re turning 65 soon, sign up for BOTH Part A and Part B during your Initial Enrollment Period. Don’t delay Part B unless you have qualifying employer coverage.
  2. If you already have Medicare, make sure you have both Part A and Part B. Check your Medicare card — it shows your coverage.
  3. Add Part D for prescription drug coverage. Without it, you pay full price for medications AND face a late penalty later.
  4. Consider Medigap to cover the 20% Part B coinsurance and the $1,736 Part A deductible. A Medigap plan protects you from large surprise bills.
  5. Use your free preventive services. Annual wellness visit, cancer screenings, flu shots — they’re all covered at $0 under Part B. Take advantage of them.
  6. Call SHIP at 1-877-839-2675 if you need free help understanding your Medicare coverage.

Part A and Part B are the foundation of your Medicare coverage. Together, they cover hospitals, doctors, preventive care, and much more. Make sure you have both — and consider adding Part D and Medigap for complete protection.

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