What Does Medicare Assignment Mean?
Medicare assignment means a doctor, provider or supplier agrees to accept the Medicare-approved amount as full payment for a covered service.
What Does Original Medicare Cover?
Last Modified: 10/05/2026 | Reviewed by Keith Armbrecht (NPN 634015)
Quick Summary
Original Medicare consists of Medicare Part A and Medicare Part B and covers most medically necessary hospital, physician, outpatient, diagnostic, preventive and other healthcare services that meet Medicare’s coverage requirements.
Part A primarily covers inpatient hospital and related care.
Part B primarily covers doctors, outpatient healthcare, preventive services and medical equipment.
Original Medicare covers a lot, but it doesn’t cover everything.
Key Facts
- Original Medicare = Part A + Part B.
- Part A primarily covers inpatient hospital care.
- Part A can cover qualifying skilled nursing care.
- Part A covers qualifying hospice.
- Part B covers physicians.
- Part B covers outpatient care.
- Part B covers many preventive services.
- Part B covers qualifying durable medical equipment.
- Original Medicare generally lets you use any provider nationwide who accepts Medicare.
- Original Medicare generally doesn’t require prior authorization for most services.
- Original Medicare has no general annual out-of-pocket maximum.
- You can add Part D.
- You can purchase Medigap to help with cost sharing.
What Medicare Part A Covers
Part A helps cover:
Inpatient Hospital Care
When you’re formally admitted and Medicare requirements are met.
Skilled Nursing Facility Care
Limited skilled nursing or rehabilitation coverage when Medicare’s requirements are satisfied.
Hospice
For qualifying terminally ill Medicare beneficiaries.
Home Healthcare
Certain qualifying home healthcare services.
What Medicare Part B Covers
Part B can cover:
- Doctors
- Specialists
- Outpatient surgery
- Diagnostic testing
- X-rays and imaging
- Physical and occupational therapy
- Preventive services
- Durable medical equipment
- Ambulance services under applicable conditions
- Certain medications administered in a medical setting
- Other medically necessary services
What Do You Pay?
Original Medicare doesn’t normally pay 100%.
For example, for many Part B services:
After the annual Part B deductible, Medicare generally pays:
80%
and you’re responsible for:
20%
of the Medicare-approved amount.
Is There an Annual Maximum?
No general annual Part A/Part B out-of-pocket maximum applies to Original Medicare by itself.
That’s an important distinction from Medicare Advantage.
How Can You Fill the Gaps?
People with Original Medicare may choose:
Medicare Supplement insurance
to help pay applicable Medicare cost sharing.
They may also add:
Medicare Part D
for outpatient prescription drug coverage.
Video Explanation from Keith
What Original Medicare Really Covers
Keith's Take
Original Medicare is very good medical coverage, but I don’t recommend thinking of it as complete coverage by itself.
The biggest issue is that there is no general annual out-of-pocket cap on your Part A and B expenses.
That’s why the conversation normally becomes:
Original Medicare + Medigap + Part D
versus
Medicare Advantage.
Understand Original Medicare first, then decide how you want to handle the gaps.
Keith Armbrecht
Medicare on Video
Frequently Asked Questions
Q. What is Original Medicare?
A. Medicare Part A and Part B.
Q. Does Original Medicare cover hospital stays?
A. Yes, qualifying inpatient hospital care is primarily covered through Part A.
Q. Does it cover doctors?
A. Yes, mainly through Part B.
Q. Does it cover prescriptions?
A. Certain drugs are covered by Part B under specific circumstances, but most outpatient prescription coverage requires Part D.
Q. Can I see any doctor?
A. You can generally see any doctor or hospital nationwide that accepts Medicare.
Q. Does Original Medicare have a network?
A. Not in the traditional Medicare Advantage sense.
Q. Does Original Medicare have an annual out-of-pocket maximum?
A. No.
Q. Can I add Medigap?
A. Yes, if you're eligible to purchase a policy.
Official Government Sources
Explore Related Guides
Does Medicare Cover Durable Medical Equipment?
Medicare Part B covers medically necessary durable medical equipment, or DME, when prescribed for use in your home and Medicare’s requirements are met.
