What Is the Difference Between Each Medicare Part?

Whether you’re approaching age 65, supporting a loved one, or simply planning ahead, chances are you’ve heard of Medicare. But understanding how it actually works is another matter. Medicare is a federal health insurance program primarily for older adults and people with disabilities. While it's widely recognized for helping with healthcare costs in retirement, the program includes multiple parts—each with its own rules, costs, and types of coverage.

Medicare is divided into four distinct parts: A, B, C, and D. Knowing how these parts work together, and how they differ is the first step to making confident decisions about your coverage. In this guide, we’ll focus especially on the two foundational pieces of the program: Medicare Part A and Medicare Part B. Whether you’re comparing plans, preparing for enrollment, or just trying to understand what each part includes, this article is for you.

Let’s start by breaking down each part of Medicare so you can see how they fit into the bigger picture.

Overview of All Four Parts of Medicare

Before we dig into the differences between Medicare Part A and Part B, it’s helpful to understand how all the Medicare parts work together. Here’s a quick breakdown of what each one covers:

Medicare Part A – Hospital Insurance

Part A is often referred to as “hospital insurance.” It primarily covers care that takes place in a hospital or other inpatient setting. This includes:

• Inpatient care in hospitals, including room, nursing, meals, and medications

• Skilled nursing facility care after a qualifying hospital stay

• Hospice care for individuals with a terminal illness

• Limited home health care when medically necessary

Most people qualify for premium-free Part A if they or their spouse paid Medicare taxes for at least 10 years while working.

Medicare Part B – Medical Insurance

Part B is your outpatient medical coverage. It helps pay for:

• Doctor’s visits, including specialists

• Outpatient care and procedures

• Preventive services like screenings, flu shots, and wellness visits

• Durable medical equipment (e.g., wheelchairs, oxygen, walkers)

Unlike Part A, Part B comes with a monthly premium, an annual deductible, and 20% coinsurance for most covered services.

Medicare Part C – Medicare Advantage

Also known as Medicare Advantage, Part C is an alternative to Original Medicare (Parts A and B). These plans are offered by private insurers approved by Medicare and often include:

• All benefits of Part A and Part B

• Part D (prescription drug coverage)

• Extras like dental, vision, hearing, and gym memberships

Many plans operate with provider networks (HMO or PPO) and have out-of-pocket caps, unlike Original Medicare.

Medicare Part D – Prescription Drug Coverage

Helps cover prescription medications, not included in Parts A or B. This is available as a standalone plan (to pair with Original Medicare) or included in many Part C plans.

Plans vary in:

• Formularies (list of covered drugs)

• Monthly premiums

• Copays and coinsurance

What Is the Difference Between Medicare Part A and Part B?

Now that you have a full picture of Medicare’s structure, let’s dive into the key differences between Medicare Part A and Medicare Part B, the two pillars of Original Medicare.

What Medicare Part A Covers

Think of Part A as coverage for your inpatient needs. It steps in when you are admitted to a hospital or facility for treatment. Here's what it includes:

• Inpatient Hospital Care: This includes semi-private rooms, meals, general nursing, and hospital services and supplies.

• Skilled Nursing Facility (SNF) Care: After a qualifying three-day hospital stay, Part A may cover short-term SNF care to help with recovery.

• Hospice Care: If you have a terminal illness and meet certain conditions, Medicare may cover hospice services to provide comfort and support.

• Home Health Care: Part A covers limited home health services, particularly when you're homebound and need intermittent skilled nursing or therapy services.

Most beneficiaries do not pay a monthly premium for Part A if they have a sufficient work history (at least 40 quarters of Medicare-covered employment).

What Medicare Part B Covers

Medicare Part B covers a wide range of outpatient services that help you stay healthy or treat illnesses that don’t require hospitalization. Covered services include:

• Physician Services: Visits to primary care doctors and specialists.

• Outpatient Care: Includes diagnostic tests, minor surgical procedures, and emergency room care that doesn’t lead to inpatient admission.

• Preventive Services: Such as annual wellness exams, vaccines (including flu, COVID-19, and others), cancer screenings, and cardiovascular screenings.

• Medical Equipment: Durable medical equipment (DME) like walkers, canes, wheelchairs, and home oxygen services.

Unlike Part A, Part B has a monthly premium—most people will pay around $185 in 2025, though higher-income earners may pay more. There’s also an annual deductible and 20% coinsurance for most covered services after the deductible is met.

How Enrollment and Costs Differ Between Part A and Part B

Understanding when and how to enroll in Parts A and B—and what you’ll pay—can help you avoid late penalties and unexpected bills.

Enrollment Rules

Medicare Part A enrollment is often automatic if you’re already receiving Social Security or Railroad Retirement Board benefits when you turn 65. You’ll receive your red, white, and blue Medicare card in the mail, and coverage typically begins on the first day of the month you turn 65. If you’re not collecting benefits yet, you’ll need to sign up manually through the Social Security Administration.

Medicare Part B, on the other hand, may require active enrollment if you’re not yet receiving Social Security benefits. You have a 7-month Initial Enrollment Period (IEP), starting 3 months before your birthday month and ending 3 months after. If you miss this window and don’t qualify for a Special Enrollment Period—such as if you’re covered by an employer plan—you may have to wait until the General Enrollment Period (January 1–March 31), with coverage starting July 1. Late enrollment can result in a 10% premium penalty for each 12-month period you delay signing up.

Costs and Premiums

Medicare Part	Typical Premium	Deductible	Coverage Type
Part A	$0 (if you paid taxes for 10 years)	$1,632 per benefit period (2024)	Inpatient
Part B	$185/month (2025 est.)	$240/year (2025 est.)	Outpatient

Other out-of-pocket costs:

• Coinsurance: After meeting your deductible, Part B generally covers 80% of approved services. You’ll pay the remaining 20% out of pocket, with no annual cap under Original Medicare.

• Hospital stays: While Part A covers most of your inpatient care, you may still owe daily coinsurance for longer hospital stays (over 60 days) and for skilled nursing care after certain limits.

• What’s not covered: Neither Part A nor Part B covers routine dental care, vision exams or eyeglasses, hearing aids, or most prescription drugs. Many people choose to add Part D or enroll in a Medicare Advantage plan to fill these gaps.

Frequently Asked Questions

Which Is Better, Medicare Part A or Part B?

There’s no winner between Part A and Part B—they’re designed to work together. Think of it like this:

• Part A = Inpatient Care (hospital stays, skilled nursing)

• Part B = Outpatient Care (doctor visits, screenings, durable medical equipment)

Together, they form Original Medicare, and most people enroll in both to ensure they’re covered across the full range of medical needs.

Is Medicare Part B Free at Age 65?

No—Part B is not free. Most people pay a monthly premium (projected to be around $185 in 2025). However, financial assistance is available for those who qualify.

If your income is limited, programs like Medicare Savings Programs (MSPs) can help pay for Part B premiums. If you’re also eligible for Medicaid, it may cover your Part B costs in full. Unified Health’s licensed advisors can help you check eligibility and apply for assistance programs.

Do I Need Both Part A and Part B?

Yes, if you want comprehensive coverage, it’s highly recommended to enroll in both. Having only Part A limits your benefits to hospital-based care. Without Part B, you may be responsible for 100% of doctor visits, outpatient services, and preventive care costs—which can add up quickly.

If you plan to enroll in a Medicare Advantage Plan (Part C), you still need to be enrolled in both Part A and Part B.

What About Part C and Part D?

If you’re looking for all-in-one coverage, Part C (Medicare Advantage) may be an appealing option. These plans bundle Parts A and B, often include Part D, and may offer extras like:

• Dental and vision coverage

• Hearing aids

• Wellness programs

• Out-of-pocket spending caps

Part D specifically helps with prescription drug costs, which are not included in Parts A or B. You can add a standalone Part D plan to Original Medicare or get it bundled within a Medicare Advantage plan.

Final Thoughts: Understanding the Full Picture of Medicare

Choosing the right Medicare coverage can feel overwhelming—but breaking it down into its parts makes it more manageable.

Here’s a quick recap:

• Part A covers inpatient care like hospital stays and skilled nursing facilities. Most people get it for free.

• Part B covers outpatient services, doctor visits, and preventive care. It comes with a monthly premium and some out-of-pocket costs.

• Most people choose to enroll in both A and B to ensure comprehensive coverage under Original Medicare.

• Part C and D offer optional ways to bundle or enhance coverage, depending on your needs.

If you're approaching 65 or helping someone navigate their options, understanding how these parts work together is the first step to choosing the right plan.

At Unified Health, our licensed advisors are here to guide you through your Medicare journey. Whether you're comparing plans, checking eligibility, or exploring ways to save on premiums, we’ll help you find the best path forward.

Learn More about how Unified Health can help you enroll in the right Medicare plan today.

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