Yes, Medicare has deductibles, and they vary by part

Medicare Part A (hospital insurance) and Part B (medical insurance) both have deductibles you pay before Medicare starts to cover costs. Part D (prescription drugs) also has a deductible. The amounts change each year, and they are different for each part. Part C (Medicare Advantage) plans set their own deductibles, which can be lower, higher, or zero depending on the plan you choose.

A deductible is the amount you pay out of your own pocket for covered services before your insurance starts paying its share. Once you meet the deductible, you typically pay a copay (a fixed dollar amount per visit) or coinsurance (a percentage of the cost), and Medicare covers the rest.

Key Takeaways

  • Part A has a deductible per hospital stay (not per year), and Part B has an annual deductible that resets every January.
  • Part D prescription drug plans have annual deductibles that vary by plan, usually between $0 and several hundred dollars.
  • Medicare Advantage plans (Part C) set their own deductibles, so two plans may have very different out-of-pocket costs for the same service.
  • You can see the exact deductible amounts for any plan during the annual enrollment period using Medicare.gov's plan comparison tool.

Part A deductible: what it covers and how it resets

Part A covers 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 hospital or skilled nursing care. If you go back to the hospital after that 60-day break, a new benefit period starts and you pay 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 separated by at least 60 days. After you meet the deductible for that benefit period, you pay coinsurance (a percentage of costs) for days 1 through 60 of a hospital stay, a higher coinsurance amount for days 61 through 90, and an even higher amount for lifetime reserve days beyond that.

Part B deductible: annual and applies to most services

Part B covers doctor visits, outpatient care, medical equipment, and preventive services. The deductible resets on January 1 each year. Once you pay the deductible, you typically pay 20 percent coinsurance for most services, and Medicare pays 80 percent.

Some preventive services (like annual wellness visits, cancer screenings, and vaccines) have no deductible or coinsurance—Medicare covers them fully. Other services, like physical therapy or mental health visits, may have different cost-sharing rules. You can find a full list of what is covered on Medicare.gov.

Part D deductible: prescription drug plans vary widely

Part D is prescription drug coverage offered through private insurance companies approved by Medicare. Each plan sets its own deductible, which can range from $0 to several hundred dollars per year. Some plans have no deductible at all, especially for generic drugs.

After you meet the deductible, you pay a copay or coinsurance for each prescription. The amount depends on which tier the drug is on—generic drugs usually cost less than brand-name drugs. If your yearly drug costs reach a certain threshold, you enter the "coverage gap" (sometimes called the donut hole), where you pay a larger share of the cost until you reach catastrophic coverage, at which point Medicare covers most of the cost for the rest of the year.

Medicare Advantage (Part C) deductibles: plan-specific

Medicare Advantage plans are an alternative to Original Medicare (Parts A and B). They are offered by private insurance companies and must cover everything Original Medicare covers, but they can structure deductibles and copays differently. Some plans have no deductible, some have a single deductible that applies to both hospital and doctor visits, and some have separate deductibles for different types of care.

Because each plan is different, comparing deductibles side by side is essential. A plan with a low or zero deductible might have higher copays for doctor visits, or it might include dental or vision coverage that Original Medicare does not. During the annual enrollment period (October 15 to December 7), you can use the Medicare Plan Finder tool on Medicare.gov to see the exact deductible and out-of-pocket costs for every plan available in your area.

How to find your plan's deductible amount

If you are already enrolled in Medicare, your deductible information is in your plan documents, usually sent to you in the mail before the year begins. You can also call the phone number on the back of your Medicare card and ask the customer service representative for your deductible amount.

If you are shopping for a plan, use the Medicare Plan Finder at Medicare.gov. Enter your zip code and the medications you take (if you are looking at Part D or Medicare Advantage plans), and the tool will show you all available plans, their deductibles, copays, and estimated yearly costs based on your prescriptions. You can also call 1-800-MEDICARE to speak with someone who can walk you through the options.

Supplemental insurance (Medigap) and deductibles

Medigap is supplemental insurance sold by private companies that helps pay the costs Medicare does not cover—including deductibles, copays, and coinsurance. If you have Medigap, you may pay little to nothing out of pocket for covered services, depending on which Medigap plan you choose.

Medigap plans are standardized and labeled A through N. Some plans cover the Part A deductible, some cover the Part B deductible, and some cover both. Plan G, for example, covers both the Part A and Part B deductibles, so you would not pay those amounts yourself. However, Medigap does not cover Part D prescriptions—you still need a separate Part D plan for that.

Frequently Asked Questions

Do I have to pay my deductible every year?

Part B and Part D deductibles reset on January 1 each year, so yes, you pay them annually. Part A is different—you pay the deductible per benefit period (hospital stay), not per year, so you might pay it zero times or multiple times in a single year depending on how many times you are hospitalized.

What happens if I do not meet my deductible before the year ends?

The deductible does not carry over to the next year. On January 1, it resets to zero for Part B and Part D. For Part A, the deductible applies to each new benefit period whenever that occurs, regardless of the calendar year.

Can I use my Medigap plan to pay my Medicare deductible?

It depends on which Medigap plan you have. Some plans cover the Part A deductible, some cover the Part B deductible, and some cover both. Check your Medigap plan documents or call your insurance company to see what your plan covers.

Are preventive services subject to the Part B deductible?

No. Medicare covers many preventive services (like annual wellness visits, cancer screenings, and flu shots) with no deductible and no coinsurance. However, if you see a doctor for a reason other than prevention during the same visit, that portion may be subject to the deductible.

How do I know which Medicare Advantage plan has the lowest deductible?

Use the Medicare Plan Finder tool on Medicare.gov and filter by deductible amount, or call 1-800-MEDICARE. Keep in mind that a low deductible does not always mean the lowest total out-of-pocket cost—compare copays, coinsurance, and whether the plan covers services you use regularly.