Patient getting testing done

Original Medicare Part A vs. Medicare Part B: What’s the Difference?

Medicare Part A and Medicare Part B cover specific services under Medicare. Part A pertains to inpatient hospital coverage, while Part B is for outpatient, medical coverage – think doctor’s visits and other aspects of outpatient medical care.

These plans were not meant to compete with one another, instead, they are intended to complement each other to provide health coverage at a doctor’s office and hospital.

Who qualifies for Original Medicare?

All U.S. citizens are eligible to receive Original Medicare at the age of 65. However, if you are under the age of 65, you may qualify for Medicare if you have: ALS, ESRD (End Stage Renal Disease) or have received disability income from Social Security for 24 months. In addition, you have to be lawfully present in the United States, otherwise, Medicare won’t pay for your Part A and Part B claims.

What Medicare Part A and B Covers

According to the Medicare website, besides inpatient care in a hospital, Part A Hospital Insurance can include inpatient care from skilled nursing facilities, nursing home care, hospice care, and home health care.

Part B covers outpatient services provided by doctors or other health care providers, home health care, durable medical equipment (wheelchairs, walkers, hospital beds), and most preventive services (screenings, vaccines, and “wellness” visits).

How to find out if Medicare covers what you need

The best way to find out about your Medicare coverage is to ask your doctor or health care provider if Medicare covers the services or supplies that you are required to go through or have. This is to avoid misunderstanding as some usually covered services may not be the same in your situation. If so, you’ll have to read and sign a notice which means you may have to pay for the item, service, or supply.

What is NOT covered under Medicare Part A and B?

Services not covered under Part A and B are services involving:

  • Long-term care or custodial care i.e. care for those who are unable to perform basic activities of daily living, like dressing or bathing.
  • Most dental care
  • Eye exams related to prescription glasses
  • Dentures
  • Cosmetic surgery 
  • Acupuncture 
  • Hearing aids and exams for fitting them
  • Routine foot care

New to Medicare?

If you are new to Medicare and are having trouble understanding what it can and cannot do for you, let us help guide you through the complexities of Medicare. Schedule a consultation with our Medicare Answer Team today. We are here to answer your questions.