What is the difference between Medicare Parts A and B?
The government divides Medicare coverage into parts, labeling them A, B, C, and D. Generally, Part A applies to inpatient treatment, while Part B covers visits to a doctor and some other elements of outpatient care.
Medicare is the government-funded insurance program for people ages 65 years old and over. It is also available to younger people with certain conditions and disabilities.
This article explains the key differences between Medicare Parts A and B.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Comparing Part A and Part B coverage
This article originally appeared on Medical News Today
Each part of Medicare is designed to help pay for different aspects of treatment. Parts A and B make up Original Medicare.
Part A covers many costs of inpatient care. Part B primarily covers the costs of outpatient treatment and preventive care, such as doctor visits, medical equipment, and some prescriptions.
The two parts have different out-of-pocket costs, including deductibles and coinsurance.
Medicare part A
Medicare Part A is designed to help cover inpatient care, such as:
inpatient hospital stays
hospice care
care at a skilled nursing facility
To qualify for Part A coverage, a service must involve active treatment that improves a person’s overall health. In addition, Part A covers hospice care.
It is important to note that Medicare does not cover supportive services, such as long-term care at a nursing home if healthcare professionals do not expect the person’s condition to improve.
Likewise, Medicare does not cover care at home, such as help with eating, bathing, and dressing.
Though these supportive services can be crucial, Medicare is only designed to cover active medical treatment and hospice care.
Learn more about Medicare Part A.
Medicare part B
Part B covers medically necessary services — those needed to support the diagnosis or treatment of a health problem. It also covers preventive services, such as regular checkups.
Examples of eligible services include:
most visits to a doctor
mental health treatments — inpatient or outpatient
ambulance transportation
clinical research
durable medical equipment, such as crutches
some outpatient prescription medications
Medicare has a search function that allows a person to check whether a specific service, treatment, or device is covered — and, if so, by which part.
Learn more about Medicare Part B.
Costs of Medicare Parts A and B
Medicare Parts A and B have different premiums and out-of-pocket costs.
Part A premium
The Medicare Part A premium is usually free for people who have worked for at least 40 quarters while paying Medicare taxes, as well as their spouses.
However, even for those who do not pay this premium, other out-of-pocket costs apply.
For people who do need to pay a Part A premium, the amount varies, depending on the number of quarters in which the person has paid Medicare taxes:
If a person has paid Medicare taxes for 40 or more quarters, they do not pay a premium.
If a person has paid Medicare taxes for 30–39 quarters, their premium is $285 per month.
If they have paid Medicare taxes for fewer than 30 quarters, their premium for 2025 is $518 per month.
These premiums are subject to change every year.
Part B premium
A premium also applies for Medicare Part B. For 2025, the standard monthly premium is $185.
If a person has an annual income of more than $106,000 as an individual or $212,000 alongside their spouse, they may be subject to an income-related adjustment. This adds a fee to the monthly premium.
The maximum Part B monthly premium is $628.90.
Parts A and B cost comparison for 2025
The following table breaks down the costs of Medicare Parts A and B in 2025.
Part A | Part B | |
Premium | Often free, but based on Medicare tax history | $185 or higher after income-related adjustments |
Deductible | $1,676 for each benefit period, which starts on admission as an inpatient and finishes once a person has not received care for 60 days | $257 |
Coinsurance | •$0 for inpatient days 1–60 | After meeting the deductible, 20% of the Medicare-approved cost of a treatment |
How to enroll in Medicare
The Social Security Administration (SSA) or Railroad Retirement Board (RRB) automatically enrolls some people in Medicare Parts A and B.
If a person already receives benefits from either of these administrations, they will receive a Medicare card in the mail about 3 months before their 65th birthday. The benefits usually begin on the first day of the month that they turn 65.
If a person does not get benefits from the SSA or RRB, they will have to sign up for Medicare. There are several ways to do this:
Apply online at the SSA’s website.
Call the SSA, at 1-800-772-1213 (TTY: 1-800-325-0778).
Sign up in person at a Social Security office.
A person can enroll in Medicare during the “initial enrollment period.” This extends from 3 months before the month of the person’s birthday to 3 months after it.
It is possible to enroll outside of this period, but there may be a late enrollment penalty fee.
Learn more about Medicare enrollment.
Considerations for enrolling in Part D
Medicare Part D provides prescription drug coverage. The government requires that a person has creditable drug coverage from either a private insurance policy or Medicare.
A person must have Medicare parts A or B to purchase a Part D plan. They may also purchase a Part D plan if they have a bundled policy called Medicare Advantage (Part C), as long as this policy does not already cover prescription medications.
A person can sign up for a Medicare Part D plan online. Medicare’s website provides a search function that helps with understanding coverage.
When choosing a plan, it is important to ensure that it covers any existing medications.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
Summary
Medicare Parts A and B cover different types of health services. Generally, Part A covers inpatient treatments, and Part B covers visits to doctors, some medical supplies, and some devices.
A person qualifies for premium-free Part A if they have paid Medicare taxes through employment for at least 10 years. Part B has a premium that is based on a person’s income.
Both parts require a person to pay out-of-pocket costs, including deductibles and coinsurance.
The SSA and RRB automatically enroll some people in these aspects of Medicare once they reach 65 years of age. Other people must sign up on their own.
To enroll in a Part D plan, a person must have Part A, Part B, or both, or a Medicare Advantage plan that does not cover costs of prescriptions.
View the original article on Medical News Today
