Original Medicare is the federal coverage arrangement made up of Part A and Part B. Medicare pays its share of eligible services and you pay the applicable remaining costs, unless supplemental insurance or assistance helps.
Which part pays?
| Part A | Part B |
|---|---|
| Qualifying inpatient hospital care. | Doctor and other professional services, including many billed during a hospital stay. |
| Eligible skilled nursing facility and hospice services. | Outpatient care, covered equipment and many preventive services. |
| Some qualifying home health care. | Some qualifying home health care. |
Hospital observation can remain outpatient care even overnight. Ask whether you were formally admitted; the answer affects billing and sometimes later skilled nursing eligibility. Long-term personal care is not the same as covered skilled care.
Key costs in 2026
Most people qualify for Part A without a monthly premium through work history, but hospital care still has cost sharing. The Part A hospital deductible is $1,736 per benefit period, not simply once a calendar year. Longer stays can have daily coinsurance.
The standard Part B premium is $202.90 per month and the annual deductible is $283. Income adjustments, penalties or assistance can change what a person pays. For many covered Part B services, you pay 20% of the Medicare-approved amount after the deductible. Some preventive services have different cost rules.
Providers and additional insurance
You can generally use any U.S. provider who takes Medicare. Ask whether the provider accepts assignment, which limits charges to the approved amount for covered services. Participation does not mean that every service offered is covered.
Original Medicare by itself has no annual overall out-of-pocket cap. You may consider Medigap or other supplemental coverage for specified costs and a separate Part D plan for prescription insurance. Routine dental work, ordinary glasses and hearing aids are generally outside Original Medicare’s benefits, with service-specific exceptions.
After receiving care
Review the Medicare Summary Notice or secure online claim record. Compare dates, services, approved amounts and what the provider says you owe. A summary notice is not itself a bill. Contact the provider about discrepancies and follow appeal instructions for a disputed coverage decision.
Related coverage questions
- Medicare Part A and Part B: What Each Covers
- Medicare Part B: Medical Coverage, Costs and Enrollment
- Medicare Premiums and Deductibles: 2026 Medical Costs