The 2023 Medicare Part B deductible is $226 per year

In 2023, you pay $226 out of your own pocket before Medicare Part B starts to cover your doctor visits and outpatient services. Once you have paid $226 in costs for covered services, Medicare pays its share and you pay your coinsurance — usually 20% of the cost for most services.

This deductible resets on January 1 each year. If you reach it in March, you start fresh in January of the following year. The amount changes yearly based on healthcare costs, so the 2024 deductible will be different.

The deductible applies to most Part B services: doctor office visits, lab tests, X-rays, and outpatient hospital care. It does not explore to preventive services like annual wellness visits, cancer screenings, or flu shots — those are covered at no cost to you once you meet the deductible or not, depending on the service.

Key Takeaways

  • You pay the first $226 of Part B costs each year before Medicare begins to share the cost.
  • After you meet the deductible, you typically pay 20% coinsurance for doctor visits, tests, and outpatient care.
  • The deductible does not explore to preventive services such as wellness visits and cancer screenings.
  • If you have a Medigap or Medicare Advantage plan, your out-of-pocket costs may be lower because those plans help cover the deductible.

How the deductible works with your monthly premium

Your Part B premium and your deductible are separate costs. Most people pay a monthly premium (the standard amount in 2023 was $164.90, though higher earners pay more). This premium does not count toward your deductible — you pay both.

Think of it this way: you pay your premium every month no matter what. Then, when you use Part B services, you pay out-of-pocket costs until you reach $226. After that, Medicare and you split the cost, with you paying 20% coinsurance.

If you use very few services in a year, you may never reach the $226 deductible. In that case, you still pay your monthly premium, but you do not owe the deductible because you did not use enough covered services to trigger it.

What happens after you meet the deductible

Once you have paid $226 toward covered Part B services in a calendar year, the deductible is satisfied. From that point forward, Medicare covers its portion of the cost, and you pay coinsurance — typically 20% of what Medicare approves for the service.

For example: after meeting your deductible, you see your doctor and the visit costs $100. Medicare approves $80 of that cost. Medicare pays $64 (80%), and you pay $16 (20%). The remaining $20 is a balance-billing charge that your doctor may or may not pursue, depending on whether they accept Medicare assignment.

Some services have different coinsurance amounts. Mental health visits, for instance, may have different cost-sharing rules. Your Medicare Summary Notice (the bill you receive after each service) will show exactly what you owe.

How Medigap and Medicare Advantage plans affect your deductible

If you have a Medigap (supplemental insurance) plan, that plan may pay your Part B deductible for you. Many Medigap plans cover the deductible in full, which means you do not pay it out of pocket. Check your Medigap plan documents to see whether your plan covers the Part B deductible.

If you have a Medicare Advantage plan (Part C), you have a different deductible structure. Medicare Advantage plans set their own deductibles, which may be higher, lower, or the same as the standard Part B deductible. Your Advantage plan documents will show your specific deductible amount and which services it applies to.

People with both Medicare and Medicaid (called "dual may be able to access") may have their Part B deductible covered by Medicaid, depending on their state's rules. Contact your state Medicaid office to confirm.

Services that do not count toward your deductible

Several important services are exempt from the Part B deductible. Preventive services — including your annual wellness visit, cancer screenings (mammogram, colonoscopy, prostate screening), cardiovascular screenings, diabetes screenings, and vaccinations — are covered at no cost regardless of whether you have met your deductible.

Mental health services also have special rules. While they are subject to coinsurance (you pay 20%), they are not subject to the deductible. This means you do not have to pay $226 before mental health coverage begins.

Home health services, hospice care, and durable medical equipment (like wheelchairs or oxygen) have their own cost-sharing rules and do not use the Part B deductible. Your Medicare Summary Notice will clarify which cost-sharing rule applies to each service you receive.

Tracking your deductible throughout the year

You can track how much of your deductible you have used by checking your Medicare Summary Notice, which you receive after each service. This notice shows what Medicare approved, what you paid, and how much of your deductible remains.

You can also log into your Medicare.gov account to view your claims and deductible status. Create an account at Medicare.gov if you do not have one — it takes a few minutes and lets you see your claims in real time.

If you notice a claim on your Summary Notice that you do not recognize, report it to Medicare right away. Fraudulent claims can count toward your deductible, so catching errors early protects both your wallet and your account.

Frequently Asked Questions

Does my Part B deductible carry over to the next year if I do not meet it?

No. The deductible resets on January 1 each year. If you only pay $100 toward your deductible in 2023, that $100 does not carry forward. You start fresh with a new $226 deductible on January 1, 2024.

If I have both Part A and Part B, do I have one deductible or two?

You have two separate deductibles. Part A (hospital insurance) has its own deductible, which applies to inpatient hospital stays. Part B (medical insurance) has the $226 deductible for doctor visits and outpatient services. They do not combine or overlap.

What if my doctor charges more than Medicare approves?

If your doctor accepts Medicare assignment, they can only charge you the 20% coinsurance after the deductible. If they do not accept assignment, they may bill you for the difference (called balance billing). Ask your doctor's office whether they accept Medicare assignment before your visit.

Do I pay the Part B deductible every time I see a different doctor?

No. The $226 deductible applies to all your Part B services combined, regardless of which doctor or facility provides the care. Once you have paid $226 total across all your Part B services in the year, the deductible is met for all providers.

Will my Part B deductible be higher in 2024?

The 2024 Part B deductible has not been announced yet, but it typically increases slightly each year. Medicare announces the new deductible amount in the fall before the year begins. Check Medicare.gov in October or November 2023 for the 2024 figure.