Parts A & B (Original Medicare)

There are two fundamental parts of Original Medicare: Parts A and B.

Original Medicare Part A helps cover:

  • Inpatient care in hospitals
  • Skilled nursing facility care
  • Hospice care
  • Home health care

Part A premiums for 2021

Most Medicare beneficiaries do not pay a monthly premium for Part A (sometimes called “premium-free Part A”) so long as the beneficiary or their spouse worked and paid Medicare taxes for at least 40 quarters. If the beneficiary or spouse paid Medicare taxes for fewer than 30 quarters, the standard Part A premium is $471. If the beneficiary or spouse paid Medicare taxes for 30-39 quarters, the standard Part A premium is $259.

With Part A Hospital Inpatient Deductible and Coinsurance, the Beneficiary Pays:

  • $1,484 deductible for each benefit period.
  • Days 1-60: $0 coinsurance for each benefit period.
  • Days 61-90: $371 coinsurance per day of each benefit period.
  • Days 91 and beyond: $742 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime).
  • Beyond lifetime reserve days: all costs.

Original Medicare Part B helps cover:

  • Services from doctors and other health care providers
  • Outpatient care
  • Home health care
  • Durable medical equipment (wheelchairs, hospital beds, and other equipment)
  • Many preventative services (screenings, vaccines, and related services)

Part B premiums for 2021

Medicare beneficiaries must pay a premium each month for Part B. Their Part B premium will be automatically deducted from their benefit payment if they receive benefits from:

  • Social Security
  • Railroad Retirement Board
  • Office of Personnel Management

If they do not receive these benefit payments, they’ll be billed for the premium. For 2021, the standard Part B premium amount is $148.50, and this is what most beneficiaries will pay. However, if the beneficiary’s modified adjusted income – as reported by their IRS tax return from 2 years before – is above a certain amount, they will pay an Income Related Monthly Adjustment Amount (IRMAA) in addition to their premium.

What Original Medicare does not cover

Original Medicare (Parts A & B) Does not cover the following:

  • Most Dental Care
  • Eye exams related to glasses
  • Dentures
  • Hearing Aids and fitting exams
  • Long-term care
  • Acupuncture
  • Massage Therapy
  • Cosmetic Surgery

There is a helpful IOS/Android application provided by Medicare called “What’s Covered.” Click here to learn more.