Understanding Original Medicare (Parts A & B) in 2026
When you first become eligible for Medicare, it’s important to understand what Original Medicare actually covers - and just as importantly, what it costs.
Original Medicare is made up of Part A (Hospital insurance) and Part B (Medical insurance). Together, they form the foundation of your Medicare coverage.
Let’s break it down in simple terms.
What Is Original Medicare?
Original Medicare is a federal health insurance program managed by the Centers for Medicare and Medicaid Services (CMS). It allows you to see any provider nationwide who accepts Medicare - no networks required.
However, it also comes with deductibles, coinsurance, and no out-of-pocket maximum, which is important to understand.
Medicare Part A (Hospital insurance)
What Part A Covers:
Medicare Part A primarily covers inpatient and facility-based care, including:
Hospital stays
Skilled nursing facility care
Hospice care
Some home health services
2026 Part A Costs:
$0 for most people (if you worked 40+ quarters)
$311/month (30-39 quarters)
$565/month (<30 quarters)
Deductible:
$1,736 per benefit period
Part A Coinsurance (2026)
Days 1-60: $0 after deductible
Days 61-90: $434/day
Lifetime reserve days: $868/day
Skilled nursing (days 21-100): $217/day
IMPORTANT: The Part A deductible is PER benefit period, not per year. That means you could pay it more than once in a year depending on hospitalizations.
Medicare Part B (Medical insurance)
What Part B Covers:
Part B covers outpatient and medical services, including:
Doctor visits
Preventive services
Lab work and diagnostic testing
Durable medical equipment (like walkers or oxygen)
Outpatient procedures
2026 Part B Costs:
Monthly premium: Standard $202.90/month
Higher income individuals pay more (IRMAA)
Annual Deductible: $283/year
Part B Coinsurance
After you meet the deductible:
Medicare pays 80%
You pay 20% of the Medicare-approved amount
There is no cap (no maximum out-of-pocket) on your 20%, which is one of the biggest financial risks with Original Medicare.
What Original Medicare Does NOT Cover
While Parts A and B cover a lot, there are important gaps:
Prescription drugs (Part D needed)
Dental, vision, and hearing
Long-term care (custodial care)
Most routine exams outside preventive services
The Biggest Financial Takeaways
Here’s what you need to remember about Original Medicare in 2026:
You likely pay $0 for Part A
You pay $202.90/month for Part B
You are responsible for deductibles and 20% coinsurance
There is NO out-of-pocket maximum
Because of this, many people choose to add:
A Medicare Supplement (Medigap) plan
Or a Medicare Advantage (Part C) plan
Final Thoughts
Original Medicare gives you flexibility and nationwide access to providers, but it also leaves you exposed to potentially high out-of-pocket costs.
Understanding how Parts A and B work - and what they cost in 2026 - is the first step to building the right Medicare coverage for your needs.