The basics

Original Medicare: Part A & Part B

Original Medicare is the federal government's health coverage, made up of Part A (hospital insurance) and Part B (medical insurance). It lets you see any provider in the country that accepts Medicare, covers most hospital and medical care, and pairs with a Part D drug plan and a Medicare Supplement to fill its gaps.

Reviewed by Scott Stafford, Licensed Insurance Agent

Last updated

Original Medicare is the part of Medicare run directly by the federal government. It's where most people start, and it's the foundation that every other piece of coverage builds on. It comes in two parts that work together: Part A and Part B.

What Parts A and B cover

Part A is hospital insurance. It helps pay for inpatient hospital stays, skilled nursing facility care after a qualifying hospital stay, hospice care, and some home health care. Most people get Part A without a premium because they (or a spouse) paid Medicare taxes for at least 10 years of work.

Part B is medical insurance. It helps pay for doctor visits, outpatient care, preventive services like screenings and vaccines, lab work, mental health care, and durable medical equipment such as walkers and wheelchairs. Part B has a monthly premium that nearly everyone pays.

Together, Parts A and B cover a large share of your hospital and medical care, and you can use them with any doctor or hospital in the country that accepts Medicare — no networks, no referrals.

What it costs in 2026

For most people, Part A is premium-free. When you use it, there's a $1,736 hospital deductible per benefit period in 2026, plus daily coinsurance for stays longer than 60 days. Part B costs $202.90 a month for most people, with a $283 annual deductible and then a 20% coinsurance on many covered services. Higher earners pay an income-based surcharge (IRMAA) on the Part B premium.

The catch with Original Medicare's costs: that 20% coinsurance has no annual cap on its own. For a major health event, your share could be substantial — which is the main reason people add a Medicare Supplement or choose Medicare Advantage.

What it doesn't cover

Original Medicare doesn't include prescription drugs you take at home — that's Part D. It also generally doesn't cover routine dental, vision, or hearing care, long-term custodial care, or most care outside the United States. And, as noted, it has no out-of-pocket maximum by itself.

Rounding out your coverage

Because of those gaps, most people add to Original Medicare in one of two ways:

  • a Part D plan for prescriptions, plus a Medicare Supplement (Medigap) to cover most of the deductible-and-coinsurance gap; or
  • a Medicare Advantage plan, which replaces how you get your Part A and B benefits and usually bundles drugs and extra benefits with a yearly cost cap.

You can't combine a Medicare Supplement with a Medicare Advantage plan — a Supplement only works with Original Medicare.

Original Medicare vs. Advantage

Sticking with Original Medicare (plus a Supplement and Part D) gives you provider freedom and predictable costs for a higher monthly premium. Medicare Advantage trades some of that freedom for a lower premium, built-in extras, and an out-of-pocket cap. Which fits depends on your doctors, your budget, and how much you travel. A licensed agent can compare both for your situation at no cost.

Common questions

Original Medicare FAQ

Is Part A really free?
Part A is premium-free for most people because they or a spouse paid Medicare taxes for at least 10 years. It still has costs when you use it, like the $1,736 hospital deductible in 2026.
Can I use any doctor with Original Medicare?
Yes. Original Medicare has no networks — you can see any doctor or hospital in the country that accepts Medicare, without referrals.
Do I need Part D with Original Medicare?
Original Medicare doesn't include drug coverage, so most people add a standalone Part D plan. Going without creditable drug coverage can trigger a permanent late-enrollment penalty.

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