What you'll learn
- Part A is hospital insurance: inpatient stays, skilled nursing, hospice, and some home health care.
- Part B is medical insurance: doctors, outpatient care, many preventive services, and medical equipment.
- Most people pay $0 for Part A. The standard Part B premium is $202.90 a month in 2026.
- You need both Part A and Part B to join a Medicare Advantage plan, and generally to buy a Medigap policy.
Medicare's alphabet trips up almost everyone at first. The two letters to learn first are A and B. Together they make up Original Medicare, the federal program most Texans start with at 65, whether they've lived here all their lives or just moved to be near the grandkids.
Side by side
| Part A (hospital insurance) | Part B (medical insurance) | |
|---|---|---|
| Covers | Inpatient hospital stays, skilled nursing after a qualifying stay, hospice, some home health | Doctor visits, outpatient care, ER visits, many preventive services, lab work, medical equipment, ambulance |
| 2026 premium | $0 for most people ($311 or $565 if you buy it) | $202.90 standard, more at higher incomes |
| 2026 deductible | $1,736 per benefit period | $283 per year |
| After the deductible | $0 for hospital days 1–60, then daily coinsurance | Usually 20% of the Medicare-approved amount |
| Yearly out-of-pocket cap | None | None |
These are 2026 amounts. New figures for 2027 are announced each fall.
How it plays out in real life
Say you head to the emergency room with chest pain. The ER visit, tests, and doctors' fees fall under Part B. If the doctor formally admits you as an inpatient, the hospital stay becomes Part A. The doctors who see you during that stay still bill under Part B.
If you're kept overnight under observation instead of being admitted, you're still an outpatient, so Part A pays nothing for the stay and Part B covers your services. Observation time also doesn't count toward the inpatient days Part A generally requires before it covers skilled nursing care. Our guide to Part A explains this in more detail.
This split matters in Texas, where many people in rural counties are taken to a larger city hospital for serious care. The trip, the ER, and the specialists may all be Part B, even if the hospital stay is Part A. For more on the ride itself, see how Medicare covers ambulances.
What neither part covers
- Most outpatient prescription drugs. That's Part D.
- Routine dental, vision, and hearing care
- Custodial care when it's the only care you need
- A yearly out-of-pocket limit. Original Medicare has none unless you add supplemental coverage.
Where Parts C and D fit in
- Part D adds prescription drug coverage through a private plan.
- Part C (Medicare Advantage) is a private plan approved by Medicare that replaces how you get your Part A and B benefits. It usually includes drug coverage, has a yearly limit on what you pay for covered services, and some plans include extras like dental, vision, and hearing. You still pay your Part B premium.
Many people instead add a Medicare Supplement (Medigap) policy to Original Medicare to help with deductibles and coinsurance. You can have Medigap or Medicare Advantage, but not both at once.
Signing up for each part
If you already get Social Security benefits when you turn 65, Social Security automatically enrolls you in both Part A and Part B, starting the first day of the month you turn 65. Otherwise, you sign up through Social Security, including online.
Part B's premium can run higher if your income is above certain levels. If a one-time event like retirement lowered your income, see our guide to appealing a higher Part B premium. Turning 65 soon? Start with our Texas turning-65 checklist.
The bottom line
Most people want both Part A and Part B. If you get premium-free Part A, read up on how that works. If you're still working and have job-based coverage, check whether you can delay Part B without a penalty. The bigger decision is what you add on top, and that depends on your doctors, your prescriptions, your budget, and how far you're willing to drive for care.
For free, unbiased help, Texas's HICAP counselors can be reached at 1-800-252-9240.
Common questions
Do I need both Part A and Part B?
Most people do. Part A alone leaves you without coverage for doctor visits and outpatient care. You must have both to join a Medicare Advantage plan, and you generally need both to buy a Medigap policy.
Which part covers an ER visit?
An emergency room visit is outpatient care, usually covered by Part B. If a doctor formally admits you as an inpatient, Part A covers the hospital stay, while doctors' services stay under Part B.
What are Medicare Parts C and D?
Part C is Medicare Advantage: private plans approved by Medicare that bundle Parts A and B and usually drug coverage. Part D is prescription drug coverage, sold as a stand-alone plan or included in many Medicare Advantage plans.
Sources
- Medicare.gov: Parts of Medicare
- Medicare.gov: Medicare costs
- CMS: 2026 Medicare Parts A & B premiums and deductibles
- Medicare.gov: Inpatient or outpatient hospital status
- Medicare.gov: Your coverage options
- Medicare.gov: How Medigap works
- Social Security: Medicare (2026 booklet)
- Medicare.gov: Understanding Medicare Advantage Plans (booklet)
