Original Medicare Explained

Original Medicare is Part A and Part B. Here is how it works, what it does not cover, and how people usually complete the picture.

The foundation

Original Medicare is the government program. You can generally see any doctor or hospital that accepts Medicare, anywhere in the U.S., without a plan network. After deductibles, Part B typically pays 80% of approved amounts for many outpatient services.

Gaps people often fill

Original Medicare does not include a yearly out-of-pocket maximum for Parts A and B in the same way Medicare Advantage does. Many people add Medigap to make costs more predictable, and a Part D plan for prescriptions.

What it usually does not cover

Routine dental, vision, and hearing; most long-term custodial care; and care outside the U.S. (with limited exceptions) are generally not covered. Some people value Medicare Advantage extra benefits for those gaps; others prefer Medigap plus standalone extras.

Want the full story? Get my book. Medicare 2026: Choose the Right Plan & Avoid Costly Mistakes walks through how Medicare is built. It does not pick a plan.

2026 figures

Original Medicare cost estimator

Add 2026 Part A and Part B figures for a simple yearly sketch — not a plan quote.

Read: What does Medicare Part B cost in 2027?

  • Part A deductibles: $1,736.00
  • Part A days 61–90: $0.00
  • Skilled nursing coinsurance: $0.00
  • Part B premium: $2,434.80
  • Part B deductible: $283.00
  • Part B 20% coinsurance: $343.40

Sketch of Original Medicare cost-sharing: $4,797.20

Does not include Part D, IRMAA, excess charges, Medigap premiums, or Medicare Advantage. Not a quote.

Worksheet

SNF 3-day stay and benefit period

Original Medicare skilled nursing: the 3-day inpatient rule, days 1–100, and 2026 coinsurance.

Read: Medicare skilled nursing and the 3-day stay

Where would you like to go next?