MEDICARE PART A – YOUR HOSPITAL COVERAGE
What It Is
Part A is hospital insurance. It helps cover inpatient hospital care, skilled nursing facility care after a qualifying stay, hospice, and some home health services.
What It Covers
- Inpatient hospital stays (room, meals, nursing)
- Skilled nursing facility (SNF) care (after a qualifying inpatient stay)
- Hospice care
- Some home health services when medically necessary
Costs — At a Glance
Part A may include a deductible per benefit period and daily coinsurance for longer hospital or SNF stays. Many people have a $0 Part A premium based on work history.
What This Really Means
A “benefit period” starts when you’re admitted and ends after you’ve been out of the hospital/SNF for 60 days in a row. After day 90 in one benefit period, Medicare gives you up to 60 lifetime reserve days total across your life. Once they’re used, they’re gone.
How Medigap Helps With Part A
Depending on the plan, Medigap may cover your Part A deductible, hospital coinsurance (and up to 365 additional hospital days), SNF coinsurance, and hospice cost-sharing.
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MEDICARE PART B – YOUR MEDICAL COVERAGE
What It Is
Part B helps pay for doctor and specialist visits, outpatient services, preventive care, lab tests, imaging, durable medical equipment, outpatient mental health, and some home health care.
How Costs Work
Part B generally has a monthly premium and an annual deductible; after that, Medicare typically pays 80% of approved amounts and you pay 20% with no annual cap under Original Medicare.
What This Really Means
Without supplemental coverage, the 20% coinsurance can add up. Major treatments can be expensive because Original Medicare doesn’t include an out-of-pocket maximum.
How Medigap Helps With Part B
Medigap can cover some or all of your Part B coinsurance. Some plans (like G) also cover Part B excess charges where applicable. (Benefits vary by plan.)