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Original Medicare is made up of Part A and Part B:
Part A, Hospital Coverage, is generally offered at no additional cost to qualifying individuals who have at least forty calendar quarters, ten years, of employment in any job in which Social Security taxes were paid for in the United States.
Part B, Doctors and Outpatient services, is optional coverage that requires a premium to be paid monthly. The premium will be based on, up to, the previous two years of annual income. Part B is not full coverage. There is still a deductible to be met and other out of pocket expenses.
Most people qualify for premium-free Part A, meaning they pay $0 per month. However, if you or your spouse haven’t paid Medicare taxes for at least 10 years, your monthly premium may be $285 or $518 in 2025.
The standard monthly premium for Medicare Part B in 2025 is $185. However, if your income exceeds certain thresholds, your premium may range from $259 to $628.90.
The deductible for each benefit period in 2025 is $1,676.
For 2025 the annual deductible is $257.
Days 1-60 of each benefit period: $0 after you meet the Part A deductible.
Days 61-90 of each benefit period: $419 per day.
Days 91-150 of each benefit period: $838 per day while using your lifetime reserve days (up to 60 days over your lifetime).
After lifetime reserve days are used (on day 151 of a benefit period): You are responsible for all costs.
After meeting your Part B deductible, you typically pay 20% of the Medicare-approved amount for:
Your out-of-pocket costs for Part B services depend on the type of provider you see.
Unlike many private insurance plans, Original Medicare (Part A and Part B) does not have a cap on out-of-pocket expenses. This means there’s no maximum limit to what you may need to pay for covered services after meeting your deductible.
Prescription drugs – Medicare Part A and Part B do not include coverage for most medications.
Routine vision and dental care – Eye exams, most dental procedures, and routine checkups are not covered.
Other uncovered services – Additional benefits like hearing aids and long-term care are generally not included under Original Medicare.
With Original Medicare, you are responsible for 20% of the Medicare-approved amount for Part B services—with no limit on what you could owe. This can add up quickly, especially for hospital stays, doctor visits, or ongoing treatments.
A Medicare Supplement (Medigap) plan can help cover these gaps, reducing your out-of-pocket costs and giving you peace of mind.
Don’t leave yourself unprotected—find the right Medigap plan today.
Medicare Part C, also known as Medicare Advantage:
Part C, or Medicare Advantage, is the part of Medicare that allows private health insurance companies to provide one Medicare benefit option. Medicare private health plans are known as HMOs, PPOs, PFFS, and SNP. You can choose to get your Medicare coverage through a Medicare Advantage plan instead of traditional Medicare, but you cannot have both. You cannot have Medicare Parts A and B with Part C.
Medicare Part D assists in covering the costs of prescription drugs:
Part C, or Medicare Advantage, is the part of Medicare that allows private health insurance companies to provide one Medicare benefit option. Medicare private health plans are known as HMOs, PPOs, PFFS, and SNP. You can choose to get your Medicare coverage through a Medicare Advantage plan instead of traditional Medicare, but you cannot have both. You cannot have Medicare Parts A and B with Part C.
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