Medicare Part A vs Part B — What's the Difference?

Looking for the bigger picture? See the complete Medicare in Vernal Utah guide — covers Medicare Advantage, Medigap, Part D, costs, enrollment, and local providers.

If you're approaching 65 or helping a family member navigate Medicare for the first time, the alphabet soup of Part A, Part B, Part C, and Part D can feel overwhelming. The good news: it's simpler than it looks once you understand what the two foundational pieces — Part A and Part B — actually cover.

This guide breaks down both parts in plain language so you know exactly what you're getting, what it costs, and where the gaps are that you might want to fill with a Medigap (Medicare Supplement) plan.

What Medicare Part A Covers

Part A is hospital insurance. It helps pay for care you receive as an inpatient — meaning you've been formally admitted to a hospital, not just visiting the emergency room. Specifically, Part A covers:

• Inpatient hospital stays — room, meals, nursing care, medications administered during your stay, and lab tests
• Skilled nursing facility (SNF) care — up to 100 days per benefit period following a qualifying hospital stay of at least 3 days
• Home health services — if you're homebound and need skilled nursing or therapy
• Hospice care — comfort care for terminal illness, including medication for symptom management

For most people in Vernal and the Uintah Basin, Part A is premium-free if you or your spouse paid Medicare taxes for 10 or more years. You're still responsible for deductibles and coinsurance — the 2026 Part A inpatient deductible is $1,736 per benefit period.

What Medicare Part B Covers

Part B is medical insurance. It covers the services and supplies you use outside of a hospital admission — the day-to-day medical care most people need regularly:

• Doctor and specialist visits — including appointments at Ashley Regional Medical Center, Uintah Valley Medical Center, and local clinics in Vernal
• Outpatient procedures — surgery, diagnostic tests, and lab work done without a hospital admission
• Preventive services — annual wellness visits, flu shots, cancer screenings, and diabetes monitoring — many at no cost to you
• Durable medical equipment (DME) — wheelchairs, walkers, oxygen equipment, and CPAP machines
• Mental health services — outpatient therapy and counseling
• Ambulance services — when medically necessary

The standard Part B premium for 2026 is $202.90 per month, deducted from your Social Security check. After meeting the annual deductible ($283 in 2026), Medicare typically pays 80% of approved charges — you pay the remaining 20% with no cap, which is why many people add a Medigap plan or consider Medicare Advantage.

Part A + Part B = Original Medicare

When you have both Part A and Part B, you have what's called Original Medicare. This is the foundation that every other Medicare option builds on. Original Medicare lets you see any doctor or hospital in the country that accepts Medicare — no referrals, no network restrictions. For residents of rural areas like Vernal, Naples, and Jensen, that flexibility matters when you need to travel to Salt Lake City or Grand Junction for specialty care.

However, Original Medicare has gaps. There's no annual out-of-pocket maximum, limited prescription drug coverage, and no dental, vision, or hearing benefits. That's where supplemental coverage comes in — either a Medigap plan paired with a Part D drug plan, or a Medicare Advantage plan that bundles everything together.

Side-by-Side Comparison

When to Enroll

Most people are automatically enrolled in Part A and Part B when they turn 65 if they're already receiving Social Security benefits. If you're not receiving Social Security yet, you'll need to actively sign up during your Initial Enrollment Period — the 7-month window that starts 3 months before your 65th birthday month. Missing this window can result in late-enrollment penalties that increase your Part B premium permanently. For a detailed breakdown of enrollment timing, see our guide on when to enroll in Medicare in Utah.

How a Local Vernal Agent Can Help

Understanding Part A and Part B is the starting point — but the real decisions come next. Should you stay with Original Medicare and add a Medigap supplement? Or choose a Medicare Advantage plan that replaces Original Medicare with a bundled option? The right answer depends on your doctors, your medications, your health, and your budget.

That's where local, one-on-one help makes a difference. Rocco DeLuca at Vernal Medicare sits down with Uintah Basin residents every day to compare options based on your specific situation — at no cost to you. Whether you're at Smith's Pharmacy, at home, or on the phone, the consultation is always free.