08/27/2026
đź“‹ Save this. Part A and Part B are not two halves of the same coverage. They cover different things, charge differently, and fail differently.
Part A covers inpatient care. Hospitals, skilled nursing, hospice, inpatient rehab. About 99% of enrollees pay $0 in premiums because they have 40 or more quarters of Medicare-covered work. Those who do not pay $311 or $565 per month depending on work history.
The Part A deductible is $1,736 per benefit period, not per year. A new benefit period begins 60 days after you leave inpatient care, so the same person can be charged that deductible twice in one calendar year.
Part A also tiers. Hospital days 1 to 60 cost nothing beyond the deductible. Days 61 to 90 cost $434 per day. Skilled nursing is covered in full for days 1 to 20, then costs $217 per day for days 21 to 100, and nothing after day 100.
Part B covers outpatient care. Doctor visits, lab work, imaging, outpatient surgery, preventive screenings, durable medical equipment, physical therapy. The standard premium is $202.90 per month with a $283 annual deductible.
Not everyone pays the standard premium. Some long-term enrollees pay less because of the hold harmless rule, Medicare Savings Programs cover it entirely for qualifying low-income beneficiaries, and IRMAA pushes it as high as $689.90 for incomes above $109,000 single or $218,000 married filing jointly.
The detail most people miss: after the Part B deductible, you pay 20% with no annual ceiling. Two clarifications matter here. That 20% applies to the Medicare-approved amount, not the amount a hospital bills, and the approved amount is usually far lower. But the exposure is open-ended across the year, which is what makes it dangerous. A single outpatient procedure rarely breaks anyone. Twelve months of chemotherapy, dialysis, or infusion therapy can.
That gap is the entire reason Medigap exists, and Plan G is the most common version of it.
Neither part covers prescriptions. That is Part D, which does have a cap: $2,100 in 2026.
If you delay Part B without qualifying coverage, the penalty is 10% added to your premium for each full 12 months you waited, and it is permanent. Coverage from a current employer with 20 or more employees protects you. Retiree coverage and COBRA do not.
One more for anyone still working at 65: enrolling in Part A ends your ability to contribute to an HSA.
