What’s the Difference Between Medicare Part A and Part B?
If you’ve been covered by employer-sponsored health insurance most of your life, you’re probably never had a reason to distinguish between the different parts of your coverage. Medicare, however, has separated hospital insurance (Part A) from medical insurance (Part B). Medicare Part A and B have differences in costs and coverage, but enrollment and eligibility are generally the same.
What is the difference in costs for Medicare Part A and Part B?
Medicare Part A and Part B have different premiums, deductibles, and coinsurance amounts.
|Part A||Part B|
|Premiums||Most people get premium-free Part A. You generally qualify for premium-free Part A if you’re 65 and already get retirement benefits from Social Security or the Railroad Retirement Board. You can also get premium-free Part A if you’re under 65 and got Social Security or Railroad Retirement Board disability benefits for 24 months.||Most people pay a premium for Medicare Part B. The standard Part B premium is $135.50 in 2019, or higher depending on your income.
|Deductibles||In 2019, the Medicare Part A deductible is $1,364 for each benefit period.||The Medicare Part B deductible is $185 a year in 2019.|
|Coinsurance||You pay a Part A coinsurance (a set dollar amount) for certain days in the hospital beyond day 60. This amount ranges from $341 to $682 per day in 2019.||You pay 20% of the Medicare-approved amount for most doctor services under Medicare Part B. You generally won’t know the actual dollar amount until you receive a bill.|
What is the difference of coverage for Medicare Part A and Part B?
Medicare Part A and Part B cover different things, and there is generally no overlap in coverage.
|Part A coverage||Part B coverage|
|· Your hospital room and hospital meals
· General nursing
· Prescription drugs received in the hospital
· Skilled nursing facility care
· Hospice care
· Home health care
|· Doctor visits both to primary care doctor and specialists
· Some vaccines, including the flu shot
· Mental health services
· Annual physical exam
· Durable medical equipment including wheelchairs and walkers
· Emergency ambulance transportation
· Physical, occupational, and speech therapy
· Some preventive exams, tests, and screenings
What is the difference for eligibility for Medicare Part A and Part B?
People 65 and older and people with disabilities, End Stage Renal Disease, or Lou Gehrig’s disease are generally eligible for Medicare. You also must be a U.S. citizen or a permanent legal resident for at least five continuous years. You become eligible for Medicare Part A and Part B at the same time.
What is the difference for enrollment in Medicare Part A and Part B?
You may be enrolled in Medicare Part A and Part B automatically if:
- You’ve been receiving Social Security or Railroad Retirement Board benefits for at least 4 months before you turn 65.
- You’ve been receiving disability benefits for 24 months.
If you’re still working when you turn 65, you may not be automatically enrolled in Medicare Part A and Part B. You may choose to enroll in Medicare Part A if you can get it premium-free but delay Part B enrollment because you have to pay a premium for it.
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