Don’t Waste Money on Medicare: Part A vs Part B Breakdown
Don’t Waste Money on Medicare: Part A vs Part B Breakdown
What each part covers, what it costs, and the gaps most people don’t find out about until it’s too late
Most people approaching Medicare eligibility know they need to sign up. Far fewer understand what they’re signing up for, what it actually costs, and where the gaps are. Medicare is not a single program. It is a framework of parts, and understanding Part A and Part B is where everything starts.
Original Medicare: The Foundation
Part A and Part B are the two foundational pieces administered directly by the federal government. Together they do not cover everything and come with deductibles, coinsurance, and no out-of-pocket maximum.
Part A — Hospital Insurance
Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services.
Does NOT cover: outpatient care, doctor visits, or prescription drugs.
Part B — Medical Insurance
Covers outpatient care, doctor visits, preventive services, lab tests, and durable medical equipment.
Does NOT cover: hospital stays, most prescription drugs, dental, vision, or hearing.
“Original Medicare covers a lot. But 20% of a major medical event with no cap is not a small number. That’s the gap most people don’t see coming.”
The Part B Penalty: Don’t Skip Enrollment
The Part B Penalty: Don’t Skip Enrollment
- If you don’t enroll in Part B when first eligible without qualifying employer coverage, you’ll face a permanent late enrollment penalty
- The penalty is 10% added to your premium for every 12-month period you were eligible but didn’t enroll
- Wait 3 years to enroll and you pay 30% more than the standard premium — for life
- VA coverage does NOT count as qualifying employer coverage for Part B purposes
What Original Medicare Does Not Cover
Parts A and B do not cover dental care, routine vision exams or eyeglasses, hearing aids, most prescription drugs, or long-term custodial care. Filling these gaps requires either a Medicare Advantage plan, a standalone Part D drug plan, or a Medigap supplement.
Enrollment Timing: The Window That Matters
Your Initial Enrollment Period is a 7-month window beginning 3 months before the month you turn 65. If you are still working at 65 with qualifying employer coverage from an employer with 20 or more employees, you can delay Part B without penalty.
Let’s Make Sure You Get This Right
Sean Matteson · Licensed Insurance Agent · Medicare SpecialistThis content is for educational purposes only and is not individualized insurance or financial advice. Medicare costs and rules are subject to change annually. Visit medicare.gov for the most current information.