Original Medicare is the traditional government-administered, fee-for-service health insurance program. It is made up of two components: Part A (Hospital Insurance) and Part B (Medical Insurance). These two parts serve as the core of Medicare coverage for millions of Americans.
Medicare Part A: Hospital Insurance
Part A provides coverage for inpatient and facility-related services. Major benefits include:
- Hospital inpatient care including semi-private rooms, meals, nursing services, and drugs given during your stay
- Skilled nursing facility (SNF) care for up to 100 days after a qualifying hospital admission of at least three consecutive days
- Home health care when you are homebound and require skilled nursing or rehabilitative therapy
- Hospice services for individuals with a terminal diagnosis who opt for palliative rather than curative treatment
What Part A Costs
The majority of beneficiaries receive Part A without paying a premium, based on their employment history. You are still responsible for certain out-of-pocket expenses:
- A deductible per benefit period ($1,736 in 2026)
- Coinsurance for longer hospital stays (days 61-90 and beyond)
- Coinsurance for skilled nursing facility stays beyond day 20
Medicare Part B: Medical Insurance
Part B pays for medically necessary outpatient care and preventive services. Coverage includes:
- Physician visits and specialist appointments
- Outpatient surgeries and procedures
- Diagnostic testing such as lab work, X-rays, and MRIs
- Preventive care including annual wellness exams, vaccinations, and cancer screenings
- Durable medical equipment (DME) such as wheelchairs, walkers, and oxygen equipment
- Mental health care including outpatient counseling and therapy
What Part B Costs
Part B carries a monthly premium ($203.90 per month in 2026 for most enrollees). Those with higher incomes pay an additional amount known as the Income-Related Monthly Adjustment Amount (IRMAA). Other costs include:
- An annual deductible ($257 in 2026)
- 20% coinsurance on most covered services once the deductible has been met
Gaps in Original Medicare Coverage
Original Medicare does not cover everything. Notable exclusions include:
- Prescription drugs (a separate Part D plan or Medicare Advantage plan is needed)
- Routine dental, vision, and hearing examinations
- Long-term custodial care
Many enrollees choose to add a Medigap supplemental policy to offset out-of-pocket expenses like deductibles and coinsurance, or they switch to a Medicare Advantage plan as a substitute for Original Medicare.