What do Medicare Parts A and B (Original Medicare) cover?

Medicare Parts A & B, often called Original Medicare, are the two component parts of the federal health insurance program for people 65 years of age or older. This health insurance program is also available to younger people who qualify based on specific, existing health conditions.  

What does Medicare Part A cover?

Medicare Part A is hospital insurance that covers certain expenses incurred during an inpatient hospital stay. This includes things like your room fees, meals, operating room, and rehabilitation services as well as lab tests and X-rays. Medicare Part A also covers necessary medical supplies and drugs that are administered during your hospital stay. However, it does not cover the fees of doctors associated with your care while you are in the hospital. Medicare Part A also does not cover hospital fees considered medically unnecessary, such as private duty nursing, the television or telephone in your room (if there are separate charges for these), or personal care items such as razors and slippers.

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What does Medicare Part B cover?

Medicare Part B covers medically necessary outpatient services such as routine doctor visits, many emergency medical services, outpatient mental health services and some preventive care measures, such as flu shots. Medicare Part B also covers the equipment and tests administered during these outpatient services. Like Medicare Part A, Medicare Part B covers some medication administered during your visit but not drugs you are prescribed to take after the visit is complete.

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How do I enroll in Medicare Parts A and B?

If you are approaching the age of 65 and are receiving Social Security or Railroad Retirement Board (RRB) benefits you are automatically enrolled in Medicare Parts A and B starting the first day of the month you turn 65. You are also automatically enrolled if you are under 65 and are receiving disability benefits from Social Security or certain benefits from RRB.

If you are over 65 but not receiving Social Security or RRB benefits, or qualify because you have End-Stage Renal disease, you will need to sign up for Medicare Parts A & B benefits.

What are my Medicare Parts A and B coverage options?

Individuals who qualify for Medicare Parts A & B have the option to receive their A & B benefits through a private insurer approved by Medicare. This coverage option is called a Medicare Advantage plan, or Medicare Part C, which often allows you to get additional benefits such as eye care or dental coverage. Individuals who qualify for Medicare can also add prescription drug coverage through a private insurer via a Medicare Advantage plan that includes it, or through a standalone prescription drug coverage plan (Medicare Part D).