What Is Original Medicare: Part A and Part B?
Original Medicare is the federal Medicare program that includes Medicare Part A and Medicare Part B. Part A is
generally known as hospital insurance, and Part B is generally known as medical insurance. Together, they help pay
for many medically necessary hospital, doctor, outpatient, and preventive services.
Original Medicare is not the same as Medicare Advantage. With Original Medicare, you generally can use any
doctor, hospital, or provider in the United States that accepts Medicare. However, Original Medicare does not pay
for everything, and it does not include most routine dental, vision, hearing, or outpatient prescription drug
coverage.
Part A:
Hospital Insurance
Helps cover inpatient hospital care, skilled nursing facility care,
hospice care, and some home health care.
Part B:
Medical Insurance
Helps cover doctor visits, outpatient care, preventive services,
durable medical equipment, ambulance services, clinical lab
services, and other medically necessary services.
What Does Medicare Part A Cover?
Medicare Part A helps pay for inpatient-related care. It is often called hospital insurance because the largest
category of Part A coverage is inpatient hospital care. Part A may also cover skilled nursing facility care after a
qualifying inpatient hospital stay, hospice care, and some home health care services when Medicare requirements
are met.
Part A commonly includes:
● Inpatient hospital care when you are formally admitted as an inpatient.
● Skilled nursing facility care when Medicare rules are met; this is not the same as long-term custodial care.
● Hospice care for people who meet Medicare hospice requirements.
● Some home health care services when ordered and certified according to Medicare rules.
Need to know: Part A usually has a deductible for each benefit period, not one annual deductible. In 2026, the Part
A inpatient hospital deductible is $1,736 per benefit period. Cost-sharing can also apply for longer inpatient
hospital stays and skilled nursing facility stays.
What Does Medicare Part B Cover?
Medicare Part B helps pay for medical and outpatient services. It is often called medical insurance because it
covers many doctor services, outpatient services, preventive services, and medically necessary supplies.
Part B commonly includes:
● Doctor services and many outpatient medical services.
● Preventive services, such as certain screenings and wellness-related services.
● Durable medical equipment, such as certain walkers, wheelchairs, oxygen equipment, and related supplies when
Medicare rules are met.
● Ambulance services when medically necessary and coverage requirements are met.
● Certain outpatient mental health services, lab services, imaging, and limited outpatient prescription drugs.
Need to know: Most people pay a monthly Part B premium. For 2026, the standard Part B premium is $202.90 per
month, although people with higher income may pay more. The 2026 Part B deductible is $283. After the
deductible, people with Original Medicare commonly pay 20% of the Medicare-approved amount for many Part
B-covered services.
What Original Medicare Does Not Usually Cover
Many people compare additional coverage options after enrolling in Part A and Part B.
Original Medicare usually does not include:
● Most routine dental care, such as cleanings, fillings, dentures, or extractions.
● Most routine vision care, eyeglasses, or contact lenses.
● Most hearing exams or hearing aids.
● Most outpatient prescription drugs unless they are covered under limited Part B drug rules.
● Long-term custodial care, such as help with bathing, dressing, eating, or daily living when that is the only care
needed.
● Most care outside the United States, except in limited situations.
Original Medicare and Prescription Drugs
Original Medicare does not automatically include most outpatient prescription drug coverage. If you choose
Original Medicare and want drug coverage, you generally need to enroll in a separate Medicare Part D prescription
drug plan. If you go too long without creditable drug coverage after you are first eligible, you may face a Part D
late enrollment penalty.
Original Medicare and Out-of-Pocket Costs
Original Medicare has deductibles and coinsurance. It also does not have a built-in yearly out-of-pocket maximum
for Part A and Part B services. This means your costs can continue if you have frequent or expensive medical care
unless you have other coverage that helps pay your share, such as a Medicare Supplement Insurance policy,
Medicaid, employer or retiree coverage, or another type of qualifying coverage
Do I Need Additional Coverage?
Many people use Original Medicare as the foundation of their coverage and then decide whether to add other
coverage.
Common options include:
● Medicare Part D: Helps cover outpatient prescription drugs.
● Medicare Supplement Insurance: Also called Medigap, this may help pay some of the deductibles, coinsurance,
and copayments that Original Medicare does not pay.
● Medicare Advantage: A separate way to receive Medicare benefits through a Medicare-approved private
company. You must have both Part A and Part B to join a Medicare Advantage plan.
There is no single answer that fits everyone. Your doctors, prescriptions, budget, travel habits, employer coverage,
and local plan options should all be reviewed before making a decision.
Local Medicare Guidance in Las Vegas and Nevada
Medicare rules are federal, but your plan choices can feel very local. Provider networks, prescription drug plan
formularies, pharmacy arrangements, and Medicare Advantage availability can vary by county and by plan.
Working with a local Medicare Specialist can help you understand how the national Medicare rules connect with
plan choices available in Las Vegas, Henderson, North Las Vegas, and other Nevada communities.
Need-to-Know Points Before You Choose Coverage
1. Part A and Part B are the foundation.
You generally need both Medicare Part A and Part B before you can choose many other Medicare coverage
options, including Medicare Advantage and many Medicare Supplement policies.
2. Original Medicare is flexible with providers.
Original Medicare generally lets you use any doctor or hospital that accepts Medicare, anywhere in the United
States.
3. Original Medicare does not cover everything.
Dental, vision, hearing, most prescription drugs, and long-term custodial care usually require separate planning.
4. Part B has a monthly premium.
Most people pay the standard Part B premium, and the amount can change each year. Higher-income beneficiaries
may pay an additional amount.
5. There is no built-in annual maximum for Original Medicare.
Without other coverage, there is no yearly cap on what you may pay for Part A and Part B covered services.
6. Prescription drug timing matters.
If you do not enroll in Part D when first eligible and do not have creditable drug coverage, a late enrollment
penalty may apply later.
7. Employer coverage can change the timing.
If you or a spouse are still working and have active employer group health coverage, your Medicare enrollment
timing may depend on employer size, coverage type, and whether the coverage is based on current employment.
8. Review coverage before making changes.
Your doctors, prescriptions, hospitals, pharmacies, and expected health care needs should be reviewed before
choosing between Original Medicare with add-ons or Medicare Advantage.
FAQs: Original Medicare, Part A, and Part B
What is Original Medicare?
Original Medicare is the federal Medicare program made up of Part A and Part B. Part A helps cover
inpatient-related care, and Part B helps cover medical and outpatient services.
Is Original Medicare the same as Medicare Advantage?
No. Original Medicare is administered by the federal government. Medicare Advantage plans are offered by
Medicare-approved private companies and provide another way to receive Medicare benefits. You must have Part
A and Part B to join a Medicare Advantage plan.
Does Medicare Part A cover hospital care?
Yes, Part A generally helps cover inpatient hospital care when you are formally admitted as an inpatient and the
hospital accepts Medicare.
Does Medicare Part B cover doctor visits?
Yes, Part B helps cover doctor services and many outpatient services when they are medically necessary and
Medicare coverage rules are met.
Does Original Medicare include prescription drug coverage?
Original Medicare does not include most outpatient prescription drug coverage. Many people who stay with
Original Medicare enroll in a separate Medicare Part D prescription drug plan.
Can I see any doctor with Original Medicare?
In general, you can use any doctor, hospital, or provider in the United States that accepts Medicare. It is still
important to confirm that the provider accepts Medicare assignment when possible.
Does Original Medicare cover dental, vision, and hearing?
Original Medicare usually does not cover routine dental care, routine vision care, eyeglasses, hearing aids, or
routine hearing exams. Separate coverage may be available through other options.
Does Original Medicare have an out-of-pocket maximum?
Original Medicare does not have a built-in annual out-of-pocket maximum for Part A and Part B services. This is
why many people consider Medicare Supplement Insurance, Medicaid, employer coverage, retiree coverage, or
Medicare Advantage.
When should I enroll in Part A and Part B?
Many people enroll around age 65, but the right timing can depend on whether you already receive Social Security
benefits, whether you are still working, and whether you have active employer coverage. Some people are enrolled
automatically, while others must actively sign up through Social Security.
Who can help me understand my choices in Nevada?
A local Medicare Specialist can help you compare how Original Medicare, Part D, Medicare Supplement Insurance,
and Medicare Advantage options may work with your doctors, prescriptions, budget, and Nevada plan availability.
Original Medicare is the federal Medicare program that includes Medicare Part A and Medicare Part B. Part A is
generally known as hospital insurance, and Part B is generally known as medical insurance. Together, they help pay
for many medically necessary hospital, doctor, outpatient, and preventive services.
Original Medicare is not the same as Medicare Advantage. With Original Medicare, you generally can use any
doctor, hospital, or provider in the United States that accepts Medicare. However, Original Medicare does not pay
for everything, and it does not include most routine dental, vision, hearing, or outpatient prescription drug
coverage.
Part A:
Hospital Insurance
Helps cover inpatient hospital care, skilled nursing facility care,
hospice care, and some home health care.
Part B:
Medical Insurance
Helps cover doctor visits, outpatient care, preventive services,
durable medical equipment, ambulance services, clinical lab
services, and other medically necessary services.
What Does Medicare Part A Cover?
Medicare Part A helps pay for inpatient-related care. It is often called hospital insurance because the largest
category of Part A coverage is inpatient hospital care. Part A may also cover skilled nursing facility care after a
qualifying inpatient hospital stay, hospice care, and some home health care services when Medicare requirements
are met.
Part A commonly includes:
● Inpatient hospital care when you are formally admitted as an inpatient.
● Skilled nursing facility care when Medicare rules are met; this is not the same as long-term custodial care.
● Hospice care for people who meet Medicare hospice requirements.
● Some home health care services when ordered and certified according to Medicare rules.
Need to know: Part A usually has a deductible for each benefit period, not one annual deductible. In 2026, the Part
A inpatient hospital deductible is $1,736 per benefit period. Cost-sharing can also apply for longer inpatient
hospital stays and skilled nursing facility stays.
What Does Medicare Part B Cover?
Medicare Part B helps pay for medical and outpatient services. It is often called medical insurance because it
covers many doctor services, outpatient services, preventive services, and medically necessary supplies.
Part B commonly includes:
● Doctor services and many outpatient medical services.
● Preventive services, such as certain screenings and wellness-related services.
● Durable medical equipment, such as certain walkers, wheelchairs, oxygen equipment, and related supplies when
Medicare rules are met.
● Ambulance services when medically necessary and coverage requirements are met.
● Certain outpatient mental health services, lab services, imaging, and limited outpatient prescription drugs.
Need to know: Most people pay a monthly Part B premium. For 2026, the standard Part B premium is $202.90 per
month, although people with higher income may pay more. The 2026 Part B deductible is $283. After the
deductible, people with Original Medicare commonly pay 20% of the Medicare-approved amount for many Part
B-covered services.
What Original Medicare Does Not Usually Cover
Many people compare additional coverage options after enrolling in Part A and Part B.
Original Medicare usually does not include:
● Most routine dental care, such as cleanings, fillings, dentures, or extractions.
● Most routine vision care, eyeglasses, or contact lenses.
● Most hearing exams or hearing aids.
● Most outpatient prescription drugs unless they are covered under limited Part B drug rules.
● Long-term custodial care, such as help with bathing, dressing, eating, or daily living when that is the only care
needed.
● Most care outside the United States, except in limited situations.
Original Medicare and Prescription Drugs
Original Medicare does not automatically include most outpatient prescription drug coverage. If you choose
Original Medicare and want drug coverage, you generally need to enroll in a separate Medicare Part D prescription
drug plan. If you go too long without creditable drug coverage after you are first eligible, you may face a Part D
late enrollment penalty.
Original Medicare and Out-of-Pocket Costs
Original Medicare has deductibles and coinsurance. It also does not have a built-in yearly out-of-pocket maximum
for Part A and Part B services. This means your costs can continue if you have frequent or expensive medical care
unless you have other coverage that helps pay your share, such as a Medicare Supplement Insurance policy,
Medicaid, employer or retiree coverage, or another type of qualifying coverage
Do I Need Additional Coverage?
Many people use Original Medicare as the foundation of their coverage and then decide whether to add other
coverage.
Common options include:
● Medicare Part D: Helps cover outpatient prescription drugs.
● Medicare Supplement Insurance: Also called Medigap, this may help pay some of the deductibles, coinsurance,
and copayments that Original Medicare does not pay.
● Medicare Advantage: A separate way to receive Medicare benefits through a Medicare-approved private
company. You must have both Part A and Part B to join a Medicare Advantage plan.
There is no single answer that fits everyone. Your doctors, prescriptions, budget, travel habits, employer coverage,
and local plan options should all be reviewed before making a decision.
Local Medicare Guidance in Las Vegas and Nevada
Medicare rules are federal, but your plan choices can feel very local. Provider networks, prescription drug plan
formularies, pharmacy arrangements, and Medicare Advantage availability can vary by county and by plan.
Working with a local Medicare Specialist can help you understand how the national Medicare rules connect with
plan choices available in Las Vegas, Henderson, North Las Vegas, and other Nevada communities.
Need-to-Know Points Before You Choose Coverage
1. Part A and Part B are the foundation.
You generally need both Medicare Part A and Part B before you can choose many other Medicare coverage
options, including Medicare Advantage and many Medicare Supplement policies.
2. Original Medicare is flexible with providers.
Original Medicare generally lets you use any doctor or hospital that accepts Medicare, anywhere in the United
States.
3. Original Medicare does not cover everything.
Dental, vision, hearing, most prescription drugs, and long-term custodial care usually require separate planning.
4. Part B has a monthly premium.
Most people pay the standard Part B premium, and the amount can change each year. Higher-income beneficiaries
may pay an additional amount.
5. There is no built-in annual maximum for Original Medicare.
Without other coverage, there is no yearly cap on what you may pay for Part A and Part B covered services.
6. Prescription drug timing matters.
If you do not enroll in Part D when first eligible and do not have creditable drug coverage, a late enrollment
penalty may apply later.
7. Employer coverage can change the timing.
If you or a spouse are still working and have active employer group health coverage, your Medicare enrollment
timing may depend on employer size, coverage type, and whether the coverage is based on current employment.
8. Review coverage before making changes.
Your doctors, prescriptions, hospitals, pharmacies, and expected health care needs should be reviewed before
choosing between Original Medicare with add-ons or Medicare Advantage.
FAQs: Original Medicare, Part A, and Part B
What is Original Medicare?
Original Medicare is the federal Medicare program made up of Part A and Part B. Part A helps cover
inpatient-related care, and Part B helps cover medical and outpatient services.
Is Original Medicare the same as Medicare Advantage?
No. Original Medicare is administered by the federal government. Medicare Advantage plans are offered by
Medicare-approved private companies and provide another way to receive Medicare benefits. You must have Part
A and Part B to join a Medicare Advantage plan.
Does Medicare Part A cover hospital care?
Yes, Part A generally helps cover inpatient hospital care when you are formally admitted as an inpatient and the
hospital accepts Medicare.
Does Medicare Part B cover doctor visits?
Yes, Part B helps cover doctor services and many outpatient services when they are medically necessary and
Medicare coverage rules are met.
Does Original Medicare include prescription drug coverage?
Original Medicare does not include most outpatient prescription drug coverage. Many people who stay with
Original Medicare enroll in a separate Medicare Part D prescription drug plan.
Can I see any doctor with Original Medicare?
In general, you can use any doctor, hospital, or provider in the United States that accepts Medicare. It is still
important to confirm that the provider accepts Medicare assignment when possible.
Does Original Medicare cover dental, vision, and hearing?
Original Medicare usually does not cover routine dental care, routine vision care, eyeglasses, hearing aids, or
routine hearing exams. Separate coverage may be available through other options.
Does Original Medicare have an out-of-pocket maximum?
Original Medicare does not have a built-in annual out-of-pocket maximum for Part A and Part B services. This is
why many people consider Medicare Supplement Insurance, Medicaid, employer coverage, retiree coverage, or
Medicare Advantage.
When should I enroll in Part A and Part B?
Many people enroll around age 65, but the right timing can depend on whether you already receive Social Security
benefits, whether you are still working, and whether you have active employer coverage. Some people are enrolled
automatically, while others must actively sign up through Social Security.
Who can help me understand my choices in Nevada?
A local Medicare Specialist can help you compare how Original Medicare, Part D, Medicare Supplement Insurance,
and Medicare Advantage options may work with your doctors, prescriptions, budget, and Nevada plan availability.
Still unsure how Original Medicare fits your situation?
Medicare in Las Vegas can help you compare
your options and understand how Part A, Part B, Part D, Medicare Supplement Insurance, and
Medicare Advantage may work together.
Medicare in Las Vegas can help you compare
your options and understand how Part A, Part B, Part D, Medicare Supplement Insurance, and
Medicare Advantage may work together.