Original Medicare Explained: Parts A, B, C and D
What Medicare Parts A, B, C and D each cover, what they cost in 2026, the 80/20 split in Part B, what Original Medicare leaves out, and how a supplement and a drug plan fill the gaps.
Medicare
Original Medicare Parts A and B in New Jersey
Original Medicare is the federal program run by the government: Part A for hospital care and Part B for doctors and outpatient care. At any given time you will be using either Part A, Part B and Part D, or you will be using Part C. Jackie helps you understand each part, what it costs, and when to sign up, so the rest of your choices start on solid ground.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Garden State Medicare Solutions is not connected with or endorsed by the United States government or the federal Medicare program. Medicare has neither endorsed nor reviewed this information.
What to know before you choose
Part A is hospital insurance. It covers inpatient hospital stays, care in a skilled nursing facility after a qualifying hospital stay, hospice care and some home health care. Most people pay no monthly premium for Part A because they or a spouse paid Medicare taxes for at least 40 quarters (about 10 years) of work. If you have fewer, the 2026 Part A premium is $311 a month with 30 to 39 quarters and $565 with fewer than 30 (CMS).
Part A has a large deductible before it pays: $1,736 for each benefit period in 2026. After that, days 1 to 60 in hospital are covered. Days 61 to 90 cost $434 a day, and after that you draw on 60 lifetime reserve days at $868 a day. In a skilled nursing facility, days 21 to 100 cost $217 a day in 2026 (CMS). Medicare does not pay for long-term custodial care (Medicare.gov).
Part B is medical insurance for care outside the hospital: visits to your primary care doctor and specialists, outpatient surgery, lab work, imaging and preventive services. The standard Part B premium is $202.90 a month in 2026, and the Part B deductible is $283 a year (CMS). After the deductible it is an 80/20 split: Medicare pays 80% of the approved amount and you pay 20%, with no yearly cap on that 20% unless you add other coverage.
How the premium is paid. If you draw Social Security, the Part B premium comes out of your check. If you do not, Medicare sends you a bill every 3 months, which you can pay by mail, online or by automatic deduction from your bank account (Medicare.gov). CMS announces the 2027 Part B premium and deductible around November 2026.
Higher incomes pay more for Part B. In 2026, single people with income above $109,000 and couples above $218,000, based on the tax return from two years earlier, pay an income-related amount, starting at $284.10 a month instead of $202.90 (CMS).
A worked example, as an illustration. Say you are on Original Medicare alone, with no other coverage, and you have a five day hospital stay followed by $10,000 of Medicare-approved outpatient care and doctor visits in the same year; the $10,000 is an assumption to show the arithmetic. You pay the $1,736 Part A deductible, the $283 Part B deductible, and 20% of the rest of the outpatient bill, $1,943.40, for a total of $3,962.40, plus $2,434.80 in Part B premiums for the year. That open-ended 20% is why most people add a Medicare Supplement or choose a Medicare Advantage plan.
Original Medicare does not include most prescription drugs, routine dental, vision or hearing care, or care outside the United States. Drug coverage comes from a Part D plan, and the extras come from separate plans. From here, the two main paths are Original Medicare with a Medicare Supplement and a Part D plan, or a Medicare Advantage plan. Jackie walks you through both.
We pride ourselves in being the expert from start to finish. Consultations are by phone, Zoom, or in person, at no cost to you: call or text Jackie at (856) 727-4221.
New Jersey rules to know
You sign up for Parts A and B through Social Security, online, by phone or at a local office. Jackie explains the timing and the forms and helps you understand what to choose next; the enrollment itself is with Social Security.
New Jersey's Medicare Savings Programs can pay your Part B premium if your income and savings are limited. For 2026 the yearly income limits for a single person are $15,960 for QMB, $19,152 for SLMB and $21,546 for QI, with assets up to $9,950 ($14,910 for a couple), and you apply through the NJSave application (NJ Department of Human Services).
For a no-cost, no-obligation review, call or text Jackie at (856) 727-4221. Medicare.gov and 1-800-MEDICARE list every plan in your area if you want to check a comparison against the full list, and your county Office on Aging can point you to local programs.
How and when to enroll
- Your Initial Enrollment Period is seven months: the three months before your 65th birthday month, that month, and the three after.
- If you already get Social Security at 65, you are enrolled in Parts A and B automatically and your card arrives in the mail.
- Working past 65 with coverage from a current employer? You may be able to delay Part B, then sign up within eight months of that coverage or job ending.
- Missed it? The General Enrollment Period runs January 1 to March 31 each year, and a late penalty can apply.
- Once Parts A and B are set, choose a Medicare Supplement with a Part D plan, or a Medicare Advantage plan. Jackie compares them with you.
Common mistakes to avoid
- Missing your Initial Enrollment Period because you are not claiming Social Security yet. The Part B penalty adds 10% for each full 12 months you could have had it, for as long as you have Part B (Medicare.gov).
- Assuming any job coverage lets you delay Part B. Retiree coverage and COBRA do not count as coverage from current work.
- Relying on Original Medicare alone. The 20% you pay under Part B has no yearly limit.
- Forgetting drug coverage. Going without Part D or other creditable coverage brings its own lifelong penalty.
What Jackie checks for you
- Your 65th birthday month and your seven month Initial Enrollment Period, written on a calendar for you and your spouse.
- Whether you will get Part A with no premium, based on your own or your spouse's work record.
- If you are still working, the size of your employer and whether its plan lets you delay Part B without a penalty later.
- Whether your income could bring an income-related Part B amount, and whether you might qualify for a New Jersey Medicare Savings Program instead.
- What you will add to Parts A and B: a Medicare Supplement and Part D plan, or a Medicare Advantage plan.
Questions to ask Jackie
- When exactly should I sign up for Part A and Part B?
- I am still working at 65. Do I need Part B now?
- Will I pay a premium for Part A?
- How do I pay my Part B premium if I am not taking Social Security yet?
- What does Original Medicare leave me to pay, and how do I cover it?
How Jackie helps
- Parts A, B, C and D explained in plain English, with 2026 costs
- Your enrollment dates mapped for you and your spouse
- Working past 65 reviewed so a late penalty never starts
- Medicare Savings Program screening if money is tight
- A side by side look at Medigap with Part D versus Medicare Advantage
- One New Jersey phone number for questions all year
Who it fits
You are turning 65, retiring soon, or helping a parent who is. You want to understand Parts A and B, avoid penalties and know what to add before you choose a plan.
What does Original Medicare not cover?
Original Medicare leaves you deductibles ($1,736 for Part A and $283 for Part B in 2026) and 20% of most outpatient costs with no yearly cap. It does not cover most prescriptions, routine dental, vision or hearing care, or long-term custodial care. A Medigap plan with Part D, or a Medicare Advantage plan, fills those gaps in different ways.
Next steps
Sources: 2026 Medicare Parts A and B Premiums and Deductibles (Centers for Medicare & Medicaid Services, 2026) ; Medicare.gov: Avoid late enrollment penalties (Centers for Medicare & Medicaid Services, 2026) ; Medicare.gov: Pay Part A and Part B premiums (Centers for Medicare & Medicaid Services, 2026) ; NJ Medicare Savings Programs (QMB, SLMB, QI), 2026 limits (New Jersey Department of Human Services, 2026) ; Medicare.gov: Skilled nursing facility care (Centers for Medicare & Medicaid Services, 2026) . Reviewed 2026-10-20.
Guides
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FAQ
Original Medicare (Parts A & B): common questions
When should I sign up for Medicare Part A and Part B?
Your Initial Enrollment Period is seven months: the three months before the month you turn 65, that month, and the three months after. Signing up in the months before your birthday month lets coverage start on time.
If you are already getting Social Security, you are enrolled automatically. If you are still working with coverage from a current employer, you may be able to wait, and Jackie can check that with you.
How much does Medicare Part B cost in 2026?
The standard Part B premium is $202.90 a month in 2026 and the yearly deductible is $283. People with higher incomes pay more, starting at $284.10 a month for single filers with income above $109,000. CMS announces the 2027 amounts around November 2026.
Is there a penalty if I sign up for Part B late?
Yes. If you could have had Part B and did not sign up, the premium goes up 10% for each full 12 months you went without it, and you pay that higher premium for as long as you have Part B. Coverage from a current job can let you delay without a penalty.
Can Jackie enroll me in Parts A and B?
You enroll in Parts A and B through Social Security, online, by phone or at a local office. Jackie explains the timing, helps you understand the forms, and then helps you choose and apply for a Medicare Supplement, Part D or Medicare Advantage plan.
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Original Medicare (Parts A & B) for South Jersey and all of New Jersey: no pressure, plain answers, and a review every year.
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Content reviewed by Jackie Layser, Licensed Medicare Insurance Agent at Garden State Medicare Solutions, New Jersey, helping Medicare clients since 2008. How we source and review our content. Last updated .