Yes, Medicare has deductibles, and they vary by part

Medicare does charge deductibles — amounts you pay out of your own pocket before your coverage kicks in. The deductible amount depends on which part of Medicare you use. Part A (hospital insurance) has a deductible for hospital stays. Part B (medical insurance) has a separate deductible for doctor visits and outpatient care. Part D (prescription drug coverage) has its own deductible. Part C (Medicare Advantage) deductibles vary by plan.

The deductible amounts change each year. For 2024, the Part A deductible is $1,632 per benefit period for hospital stays, and the Part B deductible is $240 per year. Part D deductibles range from $0 to $545 depending on your plan, though many plans have no deductible at all. These numbers shift annually, so what you paid last year may not be what you pay this year.

Key Takeaways

  • Part A has a deductible per hospital stay (called a benefit period), not per year, and it covers inpatient hospital care only.
  • Part B has an annual deductible that resets each January and applies to doctor visits, lab work, and outpatient services.
  • Part D deductibles are set by each prescription drug plan and can range from zero to several hundred dollars per year.
  • After you meet your deductible, you typically pay coinsurance (a percentage) or copays (a fixed amount) for each service.
  • Medigap (supplemental insurance) can cover some or all of your deductibles, though you pay a monthly premium for that coverage.

How Part A deductibles work for hospital stays

Part A covers inpatient hospital care, skilled nursing facility care, hospice, and some home health services. When you are admitted to a hospital, you pay the Part A deductible once per benefit period — not once per year. A benefit period starts the day you enter the hospital and ends 60 days after you leave without receiving any inpatient care.

If you are readmitted to the hospital within 60 days of leaving, you do not pay another deductible — you are still in the same benefit period. But if you go home, stay out of the hospital for 60 days, and then return, a new benefit period begins and you owe the deductible again. After you pay the deductible, you then pay coinsurance for each day you stay: a fixed amount per day for days 1 through 60, a higher amount per day for days 61 through 90, and an even higher amount if you stay beyond 90 days.

How Part B deductibles work for doctor and outpatient services

Part B covers doctor visits, outpatient surgery, lab tests, imaging, and other services you receive outside a hospital. You pay a Part B deductible once per calendar year — January through December. Once you meet that deductible, you typically pay 20 percent coinsurance for most services, meaning Medicare pays 80 percent.

The deductible applies to most Part B services, but not all. For example, preventive services like annual wellness visits, cancer screenings, and vaccinations are covered with no deductible and no coinsurance. If you see a doctor who does not accept Medicare assignment (the Medicare-approved price), you may pay more than 20 percent coinsurance, and the deductible rules can work differently. Always ask your doctor's office whether they accept Medicare assignment before your visit.

Part D prescription drug deductibles and how they affect your costs

Part D plans are run by private insurance companies, and each plan sets its own deductible. Some plans have no deductible at all. Others have a deductible ranging from a few dollars to the maximum allowed by Medicare, which was $545 in 2024. You choose your Part D plan during the annual enrollment period (October 15 to December 7), and the deductible you face depends on which plan you pick.

After you meet your Part D deductible, you enter the "initial coverage" phase, where you pay a copay or coinsurance for each prescription. As you spend more on drugs throughout the year, you may enter the "coverage gap" (also called the "donut hole"), where you pay a higher percentage of drug costs. Eventually, if your spending reaches a certain threshold, you enter "catastrophic coverage," where your costs drop again. The exact amounts depend on your plan and change yearly.

Medicare Advantage (Part C) deductibles and out-of-pocket limits

If you have Medicare Advantage, you are enrolled in a private plan that covers all of Part A and Part B. These plans set their own deductibles, copays, and coinsurance — they can be lower, higher, or different from Original Medicare. Some Medicare Advantage plans have no deductible at all. Others charge a deductible for hospital stays, doctor visits, or both.

Medicare Advantage plans must include an out-of-pocket maximum, which is a yearly limit on what you pay. Once you reach that limit, the plan pays 100 percent of your covered services for the rest of the year. This is different from Original Medicare, which has no out-of-pocket maximum. In 2024, the out-of-pocket maximum for Medicare Advantage plans was $7,550 for in-network services. This can make Medicare Advantage appealing if you expect high medical costs, but the trade-off is that you may have a narrower network of doctors and hospitals.

How Medigap (supplemental insurance) covers deductibles

Medigap is supplemental insurance sold by private companies that works alongside Original Medicare (Parts A and B). Medigap policies are standardized — there are 10 different plans, labeled A through N — and each covers a different combination of costs. Some Medigap plans cover your Part A and Part B deductibles entirely. Others cover coinsurance and copays but not deductibles.

For example, Medigap Plan G covers your Part B deductible, while Plan N does not. If you want Medigap to cover your deductibles, you need to choose a plan that includes that benefit. You pay a monthly premium for Medigap coverage, so you are trading a monthly cost for lower out-of-pocket costs when you use services. The premium varies by age, location, and the insurance company, and it increases as you get older. Medigap does not cover Part D prescriptions — you still need a separate Part D plan for that.

Deductibles and preventive care: what costs nothing

Medicare covers certain preventive services with no deductible and no coinsurance or copay. These include annual wellness visits, cancer screenings (mammograms, colonoscopies, Pap tests), cardiovascular screenings, diabetes screenings, bone density tests, and most vaccinations. You pay nothing for these services as long as you see a doctor who accepts Medicare assignment and the service is ordered as a preventive measure, not to diagnose or treat a specific problem.

If your doctor finds something during a preventive visit and orders additional testing or treatment, that follow-up care may be subject to your deductible and coinsurance. For example, a colonoscopy for screening is free, but if polyps are removed during the procedure, you may owe coinsurance. Ask your doctor in advance if any additional charges might explore.

Frequently Asked Questions

Do I have to pay my Part B deductible every year?

Yes. The Part B deductible resets on January 1 each year. You pay it once per calendar year, and once you meet it, you typically pay 20 percent coinsurance for most services for the rest of that year.

What happens if I switch from Original Medicare to Medicare Advantage mid-year?

If you switch plans mid-year, any deductible you already paid on Original Medicare does not transfer to your Medicare Advantage plan. You may owe a new deductible under your Medicare Advantage plan, depending on when you switch and how the plan's deductible is structured.

Can I avoid paying deductibles?

You cannot avoid deductibles entirely if you use Medicare services, but you can reduce your out-of-pocket costs by choosing Medigap coverage that includes deductible protection, or by selecting a Medicare Advantage plan with a low or zero deductible. Preventive services also have no deductible.

Does my Part A deductible reset if I am in the hospital for more than 60 days?

No. As long as you stay in the hospital continuously or return within 60 days of leaving, you remain in the same benefit period and owe only one deductible. If you leave the hospital and stay out for 60 days or more before returning, a new benefit period begins and you owe another deductible.

What is the difference between a deductible and coinsurance?

A deductible is a fixed amount you pay before your coverage begins. Coinsurance is a percentage of the cost you pay after you meet your deductible. For example, with Part B, you pay a $240 deductible, then you pay 20 percent coinsurance for most services while Medicare pays 80 percent.