Original Medicare Parts A and B

The Medicare and Medicaid Act of 1965, ratified under President Lyndon B. Johnson, began Medicare in the United States. Under this legislation, Original Medicare Parts A and B became available to eligible seniors ages 65 and over and eligible individuals with disabilities. Part A provides hospitalization coverage, and Part B is for office visits.

Parts A and B

Original Medicare is the foundation of your Medicare coverage. Part A hospitalization coverage only includes the hospital room. Part B office visit coverage includes the bulk of Medicare benefits. Part B contains doctor visits, x-rays, emergency, ambulance, IV medications, labs, MRI’s, EKG’s, and even the doctors that treat you in the hospital.

Premium-Free Part A

Many people qualify to get Part A for free. If you are not eligible for premium-free Part A and you fail to enroll in Part A at 65, then you may be subject to a 10% penalty when you do eventually enroll in Part A. 

If you get retirement benefits through Social Security or the Railroad Retirement Board, then your Part A is free. For more details, click here. If you do not qualify for free Part A, then the price you pay is determined by how long you (or your spouse) worked and paid Medicare taxes. In most cases, if you buy Part A, you must also get Part B.

Part B: The Cost and the Penalty

You can purchase Part B even if you choose not to get Part A. If you do not get Part B when you are Medicare eligible, you may have to pay a penalty, which is 10% extra for each 12-month period that you failed to sign up after you were eligible. Most people pay the standard premium amount for Part B ($164.90 in 2023). For higher income earners, they will pay an Income Related Adjustment Amount (IRMAA), which is based on your IRS tax return from 2 years earlier