Understanding Parts A & B:
The Foundation of Your Coverage
Original Medicare is managed by the federal government. It’s important to understand that 'Medicare' does not mean 'Free.' It is a cost-sharing system with specific premiums and deductibles you must account for in your budget.
Part A: Hospital Insurance
Part A covers inpatient hospital stays, skilled nursing (SNF), and hospice. For most people, Part A is premium-free because you or your spouse paid Medicare taxes for at least 10 years.
The 2026 Costs:
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Deductible: $1,736 per benefit period. This covers the first 60 days of inpatient care.
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Coinsurance: If you stay 60 to 90 days, you face a daily charge of $434 and $868/day for days 91 and beyond.
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SNF costs: $0 (days 1-20), $217 daily (days 21-100), Days 101+ you pay 100% of all costs- Medicare does not cover after 100 days.
Part B: Medical Insurance
Part B covers doctor visits, outpatient services, lab tests, and durable medical equipment. Unlike Part A, Part B has a monthly premium that most people have deducted from their Social Security check.
The 2026 Costs:
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Monthly Premium: The standard amount is $202.90.
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Annual Deductible: $283.
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The 20% Gap: After you meet your deductible, Medicare typically pays 80%. You are responsible for the remaining 20% with no cap on out-of-pocket spending.
Why Parts A & B Aren't Enough
Original Medicare is a solid foundation, but it was never designed to be a complete safety net. Because Medicare has no 'Maximum Out-of-Pocket' limit, a single major health event can be financially devastating. Most people look for a 'bridge', like a Supplement or Advantage plan, to cover that 20% medical gap.
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However, the real threat to your retirement isn't just the doctor’s bill; it’s the cost of the recovery.
A major diagnosis like Cancer, a Heart Attack, or a Stroke creates a 'Financial Hurricane' that standard insurance doesn't see. Medicare pays the surgeon, but it doesn't pay for the specialized home care you'll need to stay out of a nursing home, the travel to out-of-area specialists, or the daily bills that keep piling up while you focus on healing.
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At Berolina Insurance Group, we educate you on Essential Protection Plans. These plans put immediate cash in your pocket when life throws a curveball, ensuring that a health crisis doesn't become an asset eater! We help you build a plan that protects your health and your lifestyle, so you never have to choose between the best care and your hard-earned nest egg.
