Medicare Explained 2026
If you’re new to Medicare or just trying to make sense of it all, you’ve likely heard the term Original Medicare — but what does that really mean? Simply put, Original Medicare consists of Part A and Part B, the foundation of your federal health insurance once you turn 65.
Here’s a clear and simple explanation of how each part works and what it covers.
What Does Medicare Part A Cover?
Medicare Part A is your inpatient hospital insurance. It kicks in whenever you’re officially admitted to a:
Hospital
Skilled nursing facility
Hospice care center
It also covers some home health care if you’re unable to travel for treatment.
Most people don’t pay a monthly premium for Part A because they’ve already paid for it through payroll taxes during their working years. If you or your spouse worked at least 10 years and paid Medicare taxes, your Part A is premium-free.
When Does Medicare Part A Apply?
As soon as you become an inpatient, Medicare Part A takes over. That includes:
Hospital stays
Skilled nursing facility care
Inpatient rehab
Hospice services
Home health care (under specific conditions)
What Does Medicare Part B Cover?
Medicare Part B covers outpatient services — basically, everything that doesn’t require you to be admitted. This includes:
Doctor visits
Lab work
X-rays and imaging
Preventive and wellness visits
Physical therapy
Outpatient surgeries
Part B also covers doctor fees if you’re hospitalized, such as:
Surgeon costs
Anesthesiology
Bedside visits
Unlike Part A, you must pay a monthly premium for Part B. Everyone enrolled in Medicare pays for it — unless you delay it because you have other creditable health insurance.
Can You Delay Part B?
Yes. If you’re still working past 65 and have creditable employer coverage (or your spouse does), you can delay Part B enrollment without a penalty. But once you lose that coverage or retire, you’ll need to enroll in Part B to avoid late penalties.
Why You Need Both Parts
Together, Part A and Part B make up Original Medicare, giving you coverage for:
Inpatient hospital stays (Part A)
Outpatient and physician services (Part B)
To get prescription drug coverage, you’ll need to add a Part D plan, and to limit out-of-pocket costs, many choose to add a Medicare Supplement (Medigap) or Medicare Advantage Plan.
Related Articles
inal Tip:
Understanding Original Medicare is the first step to building a Medicare plan that fits your health and budget needs. If you have questions, visit MedigapSeminars.org and try our new AI Medicare Chatbot — available 24/7 to give you instant, expert answers.