Differences Between Medicare Part A & Medicare Part B?

The major differences between Medicare Part A and Medicare Part B are the covered services each part of the program provides. Medicare Part A is hospital insurance; Part B is medical insurance. In addition, Medicare Part A and Part B have a different enrollment procedure and cost structure.

Enrollment

At age 65, if you are eligible to receive or are receiving Social Security benefits, you may be automatically be enrolled in Medicare Part A if you paid Medicare taxes while employed. Some Part A recipients are automatically enrolled in Part B as well. However, since you must pay a premium for Medicare Part B benefits, you have an option to refuse this coverage. If you're not automatically enrolled in Part B and wish to apply, you must first be enrolled in Part A to be eligible. You can sign up for Medicare benefits beginning three months prior to your 65th birthday. The program also conducts a general enrollment period annually during the first three months of the year.

Part A Benefits

Basic Medicare Part A helps defray the cost of hospitalization, time spent in a skilled nursing facility or nursing home, home health services and hospice care. For example, Plan A covers the cost of a semi-private hospital room, nursing care, meals and treatment services, and any drugs that are part of your treatment plan while hospitalized.

Part B Benefits

Part B of Medicare, generally referred to as medical insurance, covers the cost of healthcare services like regular physician visits, outpatient surgeries and diagnostic procedures. Preventive services and health screenings are also generally covered in full by Medicare Part B.

Possible Costs for Part A

The Medicare Part A deductible in 2015 is $1,260 per Medicare benefit period. Medicare defines a benefit period as beginning the day you become an inpatient and ending when you have gone 60 days without being an inpatient. For example, if you're hospitalized on July 1 and discharged on July 8, the benefit period would end 60 days after July 8. In an extended hospital stay of more than 60 days, you are responsible for the coinsurance each day.

Premium costs do not apply to Part A coverage if you or your spouse paid Medicare taxes while working. If you must purchase Part A coverage, you can pay as much as $407 in monthly premium cost.

Part B Expenses

Medicare beneficiaries who do not exceed income limits pay a standard monthly premium of $104.90 for Part B coverage. Premiums are based on your annual income two years prior. For example, in 2015, the cutoff is based on 2013 income. If you filed taxes on more than $85,000, you will pay a higher monthly premium for Part B Medicare benefits. This limit is set for a single taxpayer. If you were married and filed jointly, the maximum is doubled to $170,000. Part B also has an annual deductible, which was $147 at the time of this publication.

References

• Medicare.gov: Part A Costs
• Medicare.gov: Part B Costs
• Medicare.gov: What Part A Covers
• Medicare.gov: What Part B Covers
• Medicare.gov: When and How to Sign Up for Part A and Part B
• U.S. Centers for Medicare & Medicaid Services. "What's Medicare?" Accessed Jan. 28, 2020.
• U.S. Centers for Medicare & Medicaid Services. "History." Accessed Jan. 28, 2020.
• The Boards of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds. "Trustees Report & Trust Funds," Page 4. Accessed Jan. 28, 2020.
• U.S. Centers for Medicare & Medicaid Services. "Medicare Trustees Report shows Hospital Insurance Trust Fund will deplete in 7 years." Accessed Jan. 28, 2020.
• U.S. Centers for Medicare & Medicaid Services. "What Medicare Covers." Accessed Jan. 28, 2020.
• U.S. Centers for Medicare & Medicaid Services. "Enrolling in Medicare Part A & Part B," Page 5. Accessed Jan. 28, 2020.
• U.S. Centers for Medicare & Medicaid Services. "Medicare Costs at a Glance." Accessed Jan. 28, 2020.
• U.S. Centers for Medicare & Medicaid Services. "What's Not Covered by Part A & Part B?" Accessed Jan. 28, 2020.
• U.S. Centers for Medicare & Medicaid Services. "Medicare Advantage Plans." Accessed Jan. 28, 2020.
• U.S. Centers for Medicare & Medicaid Services. "Who Can Join a Medicare Advantage Plan?" Accessed Jan. 28, 2020.
• U.S. Centers for Medicare & Medicaid Services. "How to Join a Medicare Advantage Plan." Accessed Jan. 28, 2020.
• Kaiser Family Foundation. "Medicare Advantage 2020 Spotlight: First Look." Accessed Jan. 28, 2020.
• Library of Congress. "H.R.1 - Medicare Prescription Drug, Improvement, and Modernization Act of 2003." Accessed Jan. 28, 2020.
• U.S. Centers for Medicare & Medicaid Services. "How to Get Prescription Drug Coverage." Accessed Jan. 28, 2020.
• Kaiser Family Foundation. "Medicare Part D: A First Look at Prescription Drug Plans in 2020." Accessed Jan. 28, 2020.

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