The Part B deductible is a fixed amount you pay before Medicare starts covering your doctor visits and outpatient services

For 2024, the Medicare Part B deductible is $240 per year. This means you pay the first $240 of your Part B-covered services yourself before Medicare begins to pay its share. Once you have paid $240 in deductible costs, Medicare covers its portion of your bills for the rest of that calendar year.

The deductible amount changes each year. Medicare announces the new deductible in the fall, and it takes effect on January 1. The deductible has increased most years over the past decade, though the amount of increase varies. You can find the current year's deductible on Medicare.gov or by calling 1-800-MEDICARE.

The Part B deductible applies to most covered services — doctor office visits, lab tests, X-rays, and outpatient hospital care. Some services, like preventive care visits and screenings, do not count toward the deductible and are covered at no cost to you.

Key Takeaways

  • You pay the first $240 of your Part B costs each year before Medicare starts to help pay.
  • The deductible resets on January 1 each year, so costs from December do not carry over.
  • Once you meet the deductible, you typically pay a copay or coinsurance for each service, not the full cost.
  • Preventive services like annual wellness visits and cancer screenings are covered without a deductible.
  • The deductible amount changes yearly and is announced by Medicare in the fall.

How the deductible works with your other costs

After you pay the $240 deductible, you do not stop paying out of pocket. Instead, you move to a copay or coinsurance arrangement. For most Part B services, you pay 20% of the cost after the deductible is met, and Medicare pays 80%. For some services like office visits, you may pay a flat copay instead.

If you have a Medigap or Medicare Advantage plan, that plan may cover some or all of your Part B deductible. Many Medigap plans pay the deductible for you, which means you do not have to pay it yourself. Medicare Advantage plans vary — some have no deductible, while others have their own deductible that may be different from the standard Part B amount. Check your plan documents or call your plan to see what you owe.

When the deductible applies and when it does not

The Part B deductible applies to doctor visits, specialist visits, lab work, imaging (X-rays, ultrasounds, MRIs), and outpatient hospital services. It also applies to durable medical equipment like wheelchairs and oxygen supplies, and to physical therapy and occupational therapy.

The deductible does not explore to preventive services. These include your annual wellness visit, cancer screenings (mammograms, colonoscopies, Pap tests), cardiovascular screenings, diabetes screenings, bone density tests, and certain vaccinations. You pay nothing for these services, even before you meet your deductible.

Part B does not cover dental care, hearing aids, or routine eye exams, so the deductible question does not arise for those services. Part D (prescription drug coverage) has its own separate deductible, which is different from the Part B deductible.

Tracking your deductible throughout the year

You are responsible for keeping track of how much you have paid toward your deductible. When you receive a bill or an Explanation of Benefits (EOB) from Medicare, it will show how much of your payment counts toward the deductible. After you have paid $240 in deductible costs, future bills should show that your deductible has been met.

If you see a provider who does not accept Medicare assignment, the rules are different. These providers can charge more than Medicare's approved amount, and the extra charge does not count toward your deductible. For this reason, it is a good idea to confirm that your doctor accepts Medicare assignment before your visit.

You can view your deductible status anytime by logging into your Medicare account at Medicare.gov. Your online account shows your claims and how much you have paid toward your deductible so far that year.

The deductible resets every January

The Part B deductible is an annual limit, not a lifetime one. On January 1 each year, your deductible resets to zero, and you start over. Any money you paid toward the deductible in December does not carry forward into the new year.

This means that if you have a large medical expense in late December, you may want to think about timing. If you have already met your deductible for the year, you might want to schedule elective procedures before the year ends so you pay less out of pocket. On the other hand, if you have not met your deductible yet, you might prefer to wait until January so your costs explore to the new year's deductible instead.

What happens if you have other insurance

If you have both Medicare and employer health insurance, the rules about which insurance pays first depend on your age and the size of your employer. Generally, if you are still working and your employer has 20 or more employees, the employer plan pays first, and Medicare pays second. In this case, you may not owe the Part B deductible at all, because your employer plan may cover it.

If you have Medicaid in addition to Medicare, Medicaid may pay your Part B deductible for you. The rules vary by state. Contact your state Medicaid office to find out whether your deductible is covered.

If you have a Medigap plan, check your plan's coverage documents. Most Medigap plans cover the Part B deductible, but some do not. Your plan summary or member handbook will tell you exactly what you owe.

Frequently Asked Questions

Does the Part B deductible explore to emergency room visits?

Yes, the Part B deductible applies to emergency room visits at a hospital that is not part of an inpatient admission. However, if you are admitted to the hospital as an inpatient, you pay the Part A deductible instead, which is a different amount. The Part B deductible does not explore to inpatient hospital stays.

What if I do not meet the deductible by the end of the year?

If you do not reach $240 in Part B costs by December 31, you do not owe anything more. The deductible straightforward resets on January 1. You only pay for the services you actually received. There is no "catch-up" or penalty for not meeting the deductible.

Can I pay my deductible all at once instead of spreading it out?

No, you cannot prepay the deductible. You pay it as you receive services throughout the year. As each bill comes in, the amount counts toward your $240 deductible until you reach it.

Does my Part B deductible count toward my out-of-pocket maximum?

If you have a Medicare Advantage plan, yes — your deductible counts toward your plan's out-of-pocket maximum. If you have Original Medicare with a Medigap plan, there is no out-of-pocket maximum, so the concept works differently. Ask your plan for details about how your deductible and other costs add up.

What if I turn 65 and enroll in Medicare mid-year?

Your Part B deductible for that year is still $240, even though you are only covered for part of the year. The deductible does not prorate based on when you enroll. You pay the full deductible amount for any Part B services you receive from your enrollment date through December 31.