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What Is a Deductible?

While on Medicare, you will typically experience an insurance deductible. It’s easy to get the concept of deductibles confused with that of copayments, premiums, coinsurances, or more. Medicare has different deductible amounts for Part A, Part B, and Part D. You may or may not pay your deductible depending on your eligibility and retirement status, the specific plan you choose, or if you have a Medicare Supplement.

What Is a Deductible?

A deductible is the amount of money you pay out-of-pocket before your insurance plan begins to pay. Typically, deductibles are different depending on the various plans you can choose from. In the scope of Medicare, the Part A deductible and Part B deductible is consistent because all Part A and Part B plans are the same. However, because the plans for Part D vary, the deductibles will be different depending on the plan you choose.

Medicare Part A Deductible

Medicare Part A, your inpatient hospital coverage, has a deductible of $1,364 for each benefit period. For example, if you are admitted to the hospital for any reason, you must first pay $1,364 out-of-pocket before Medicare begins paying for anything related to your health coverage costs.

It is important to note that even after you meet your deductible, this does not mean that you will be free of costs. Depending on the amount of time you remain in the hospital, you might have to pay coinsurance fees. The deductible only ensures that your insurance initially kicks in, providing you with as much coverage as possible for as long as the policy states.

This $1,364 deductible is for both hospital inpatient stays and mental health inpatient stays.

Medicare Part B Deductible

For all beneficiaries, the annual deductible for Medicare Part B in 2019 is $185. Once you meet your annual deductible for Part B, you will typically pay 20% of all the remaining Medicare-approved costs. You will have to pay this deductible for any service that Part B would typically cover. This includes all doctor visits, outpatient therapy, durable medical equipment, and more.

Medicare Part D Deductible

Most beneficiaries will typically pay a deductible for Medicare Part D. This annual deductible will be up to $415 in 2019 but will vary from plan to plan. You must meet your annual deductible before you start to receive the benefits of your Part D prescription drug benefits.

If you do not have a Part D plan, we recommend that you enroll in one if you take any prescription drugs. You can follow our step-by-step guide to learn how to find, compare, and enroll in a Part D plan to begin receiving coverage benefits.

Medicare Supplement Plans Can Pay Deductibles

Depending on the plan, a Medicare Supplement plan might cover or help pay your Medicare deductibles. You can only get a Medicare Supplement plan if you have Original Medicare. Once you determine your eligibility, you can sort through the different plans to find the right one for you. Not every Medicare Supplement plan will cover your Medicare deductibles, but most of them will partially cover at least one of those expenses. While most Medicare Supplement plans are standardized, plans in Massachusetts, Minnesota, and Wisconsin may vary. These states have their own Medicare Supplement plan types.

Nothing on this website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

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