What You'll Pay Out of Pocket: Medicare Deductibles Explained

Medicare has four separate deductibles, and they change every year

Medicare Part A (hospital insurance) and Part B (medical insurance) each have their own deductible you pay before coverage kicks in. Part D (prescription drugs) has a third deductible. If you have a Medigap or Medicare Advantage plan, you may have a fourth deductible for that plan. The amounts are set by federal law and announced in the fall for the following year, so they shift annually.

The deductible amounts for 2024 are: Part A is $1,632 per benefit period, Part B is $240 per year, and Part D varies by plan. These numbers will be different in 2025 and beyond. Knowing which deductible applies to which service helps you understand what you'll actually pay when you see a doctor, go to the hospital, or fill a prescription.

Key Takeaways

Part A has a deductible of $1,632 per benefit period (a hospital stay or series of related hospital stays), and Part B has a $240 annual deductible for doctor visits and outpatient care.
Part D prescription drug deductibles range from $0 to several hundred dollars depending on which plan you choose, and you can compare them during open enrollment.
Once you meet a deductible, you still pay copayments or coinsurance for most services — the deductible is not the same as your total out-of-pocket cost.
Medigap plans cover some or all of your Medicare deductibles, while Medicare Advantage plans may have their own deductibles in addition to or instead of the standard ones.
Deductible amounts change each year, so check the current amounts on Medicare.gov or call 1-800-MEDICARE before the year begins.

Part A deductible: what you pay for hospital and skilled nursing care

Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services. The deductible applies per benefit period, not per year. A benefit period begins the day you enter the hospital and ends 60 days after you leave without receiving any inpatient hospital or skilled nursing care.

If you go back into the hospital within 60 days of leaving, you are still in the same benefit period and do not pay the deductible again. If you stay out for 60 days or more and then return, a new benefit period begins and you owe the deductible again. This means you could pay the Part A deductible more than once in a single calendar year if you have multiple hospital stays.

After you meet the deductible, you pay coinsurance (a percentage of the cost) for days 4 through 60 of a hospital stay, and a different coinsurance amount for days 61 through 90. Skilled nursing facility care has its own coinsurance structure after the deductible is met.

Part B deductible: what you pay for doctor visits and outpatient services

Part B covers doctor visits, outpatient surgery, diagnostic tests, physical therapy, and durable medical equipment. You pay a $240 annual deductible (for 2024) before Part B coverage begins. Once you meet it in a calendar year, you do not pay it again until January 1 of the next year.

After you meet the deductible, you typically pay 20 percent coinsurance for most Part B services, and Medicare pays 80 percent. Some services like preventive care (annual wellness visits, screenings, vaccines) are covered at no cost after you meet the deductible.

The Part B deductible is separate from the Part A deductible. You could owe both in the same year if you have a hospital stay and also see doctors for outpatient care.

Part D deductible: what you pay for prescription drugs

Part D is prescription drug coverage offered by private insurance companies approved by Medicare. Each plan sets its own deductible, which can range from $0 to several hundred dollars. Some plans have no deductible at all, while others require you to pay out of pocket for drugs until you reach the deductible amount.

Once you meet the Part D deductible, you pay a copayment or coinsurance for each prescription. The amount depends on which tier the drug is on (generic, preferred brand-name, non-preferred brand-name, or specialty) and which plan you chose. You can compare Part D plans and their deductibles during the annual open enrollment period (October 15 to December 7) on Medicare.gov or by calling 1-800-MEDICARE.

Part D deductibles are separate from Part A and Part B deductibles. You may owe all three in the same year.

How Medigap plans affect your deductibles

Medigap (also called Supplemental Insurance) is sold by private insurers and designed to cover costs that Original Medicare leaves you responsible for — including deductibles. Depending on which Medigap plan you buy (Plan A, B, C, D, and so on), the plan may pay your Part A deductible, Part B deductible, or both.

Some Medigap plans cover the full deductible amount, while others cover part of it. Plan A, for example, covers your Part B deductible but not your Part A deductible. Plan C covers both. You pay a monthly premium for Medigap coverage, and the premium varies by age, location, and the plan letter you choose.

Medigap does not cover Part D deductibles. If you have Medigap and Part D, you still owe the Part D deductible when you fill prescriptions.

How Medicare Advantage plans handle deductibles

Medicare Advantage (Part C) is an alternative to Original Medicare, offered by private insurers. These plans must cover everything Original Medicare covers, but they can structure deductibles and cost-sharing differently. Some Medicare Advantage plans have no deductible, while others have a single deductible that applies to all services, or separate deductibles for different types of care.

Medicare Advantage plans often have lower or no deductibles than Original Medicare, but they typically include network restrictions — you must use doctors and hospitals in the plan's network, except in emergencies. They also usually include Part D prescription drug coverage built in, with its own deductible or copayment structure.

When comparing Medicare Advantage plans during open enrollment, check the deductible amounts, copayments, and coinsurance for the services you use most often. A plan with a lower deductible may have higher copayments, so the total cost depends on your health needs.

Deductibles change every year — how to stay current

Medicare deductible amounts are announced each fall for the following calendar year. The Centers for Medicare & Medicaid Services (CMS) publishes the new amounts in October, and they take effect January 1. You can find the current and upcoming deductible amounts on Medicare.gov under "Costs at a Glance," or call 1-800-MEDICARE to speak with a representative.

If you have a Medigap or Medicare Advantage plan, your insurer will send you a notice in the fall explaining any changes to your plan's deductibles and costs for the next year. Open enrollment (October 15 to December 7) is when you can switch plans if the new deductibles or costs are higher than you want to pay.

Frequently Asked Questions

Do I have to pay all four deductibles in the same year?

If you have Original Medicare with Part D, you could owe Part A, Part B, and Part D deductibles in the same calendar year. Part A and Part B deductibles are separate, so you may owe both if you have a hospital stay and also see doctors. Part D is separate from both. If you have Medigap, your plan may cover some or all of these deductibles depending on which plan letter you have.

What happens if I don't meet my deductible in a year?

Deductibles do not roll over. If you have a $240 Part B deductible and only spend $100 on covered services in a year, the remaining $140 is lost. On January 1, your deductible resets to $240. Part A deductibles reset when a new benefit period begins, not on a calendar year.

Can I see what my deductible will be before I sign up for a plan?

Yes. During open enrollment, you can view deductible amounts for every available plan on Medicare.gov's plan comparison tool, or call 1-800-MEDICARE. If you are new to Medicare, you can see deductible amounts before you enroll. Plans are required to disclose this information clearly.

Does Medicare cover my deductible if I'm low-income?

The Medicare Savings Program and Extra Help program can help pay deductibles and other out-of-pocket costs if your income and resources fall below certain limits. These programs are run by your state. You can learn more by calling 1-800-MEDICARE or visiting your state Medicaid office website.

Why is my Part A deductible so much higher than Part B?

Part A covers hospital care, which is more expensive than outpatient doctor visits, so the deductible is higher to reflect that cost difference. Part A is $1,632 per benefit period (2024) because hospital stays can cost thousands of dollars. Part B is $240 per year because most outpatient services cost less. The deductibles are set by federal law based on estimated healthcare costs.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.