How Medicare Part A and Part B deductibles work

A deductible is the amount you pay out of your own pocket before Medicare starts to pay its share. Medicare Part A and Part B each have their own separate deductible, and they reset every calendar year on January 1st. The deductible amounts change each year — they are tied to healthcare cost increases, so the exact dollar figure you will owe depends on which year you are using Medicare.

Part A covers hospital stays, skilled nursing care, and hospice. Part B covers doctor visits, outpatient care, and medical equipment. Because they are separate programs with separate deductibles, you could owe a deductible for Part A in the same year you owe a different deductible for Part B.

The deductible you owe is the same no matter which hospital or doctor you see — it is not per visit or per provider, but per benefit period (for Part A) or per calendar year (for Part B). Once you have paid your deductible, Medicare begins to cover its portion of your care, though you may still owe coinsurance (a percentage of the cost) or copays (a fixed amount per visit) depending on the service.

Key Takeaways

  • Part A and Part B each have their own deductible that resets every January 1st, and the dollar amounts change yearly based on healthcare costs.
  • Part A deductibles explore per hospital stay or benefit period, while Part B deductibles explore per calendar year.
  • After you meet your deductible, you still may owe coinsurance or copays for some services.
  • You can find the current year's deductible amounts on Medicare.gov or by calling 1-800-MEDICARE.
  • Medicare Advantage and Medigap plans may have different deductible structures than Original Medicare.

Part A deductible: hospital and skilled nursing stays

The Part A deductible covers one benefit period, not one calendar year. A benefit period begins the day you enter a hospital and ends 60 days after you leave the hospital or skilled nursing facility without receiving any inpatient care. If you are readmitted within those 60 days, you do not owe a new deductible — you are still in the same benefit period. If you are readmitted after 60 days have passed, a new benefit period starts and you owe the deductible again.

Once you have paid the Part A deductible for a benefit period, Medicare covers the full cost of your hospital stay for days 1 through 60. On days 61 through 90, you owe a daily coinsurance amount. If you stay longer than 90 days, you can use your lifetime reserve days (a limited number of extra days Medicare provides), but you will owe a higher daily coinsurance for those days. After your lifetime reserve days are exhausted, you pay all costs yourself.

Part A also covers skilled nursing facility care after a hospital stay, home health services, and hospice care. The deductible applies to your hospital stay portion; skilled nursing and home health have different cost-sharing rules once the deductible is met.

Part B deductible: doctor visits and outpatient services

The Part B deductible is a yearly amount that resets on January 1st. You pay this deductible once per calendar year, and it applies to all Part B services combined — doctor visits, lab tests, imaging, outpatient surgery, and durable medical equipment all count toward the same deductible.

After you meet your Part B deductible, Medicare typically covers 80 percent of approved charges for most services, and you pay the remaining 20 percent as coinsurance. Some services, like preventive care (annual wellness visits, cancer screenings, vaccinations), are covered at 100 percent with no coinsurance after the deductible is met. Other services, like mental health visits, may have different coinsurance percentages.

If you see multiple doctors or receive multiple services in the same year, all of those charges count toward your single Part B deductible. Once you have paid the deductible amount in total across all providers and services, you move into the coinsurance phase for the rest of that calendar year.

How deductibles differ between Original Medicare and Medicare Advantage

Original Medicare (Part A and Part B) uses the deductible structure described above. You pay the deductible, then Medicare covers its share, and you pay coinsurance or copays for the rest.

Medicare Advantage plans (Part C) are an alternative to Original Medicare offered by private insurance companies. These plans must cover everything Original Medicare covers, but they can structure deductibles and cost-sharing differently. Some Medicare Advantage plans have lower deductibles than Original Medicare, while others have higher ones. Some plans combine the Part A and Part B deductibles into a single deductible, while others keep them separate. You need to review your specific plan's documents to know what you will owe.

Medigap plans (supplemental insurance) work alongside Original Medicare. Medigap plans do not change Medicare's deductibles, but they can help pay your deductible, coinsurance, or copays depending on which Medigap plan you choose. Some Medigap plans cover the Part A deductible; others cover the Part B deductible; some cover both. Again, your specific plan determines what is covered.

Where to find the current deductible amounts

The easiest way to find the exact deductible amounts for the current year is to visit Medicare.gov and search for "deductibles" or "costs." The site lists both Part A and Part B deductible amounts, as well as coinsurance and copay amounts for different services.

You can also call 1-800-MEDICARE (1-800-633-4227) and speak with a representative who can tell you the current deductible amounts and explain how they explore to your specific situation. Representatives are available 24 hours a day, 7 days a week. If you are deaf or hard of hearing, you can use the TTY number 1-877-486-2048.

If you have a Medicare Advantage or Medigap plan, your plan's member handbook or your insurance company's website will show your plan's specific deductible amounts, which may differ from Original Medicare.

What happens if you cannot pay your deductible

If you cannot afford to pay your deductible upfront, you can still receive care. Hospitals and doctors cannot refuse to treat you because you cannot pay when ready. However, you will be responsible for paying the deductible amount eventually — it does not disappear.

Some hospitals have financial information programs or payment plans that allow you to pay your deductible over time rather than all at once. Ask the hospital's billing department or financial counselor about these options before or after your visit. Some community health centers and federally may have access to health centers (FQHCs) offer sliding-scale fees based on income, which may reduce what you owe.

If you have limited income, you may be may be able to access for Medicare Savings Programs or Medicaid, both of which can help pay Medicare deductibles, coinsurance, and copays. Your state administers these programs, and may be able to access rules vary by state. You can learn more by calling 1-800-MEDICARE or contacting your state Medicaid office.

How to track your deductible throughout the year

Keeping track of what you have paid toward your deductible helps you know when Medicare will start covering its share. For Part B, add up all the charges you have paid out of pocket for doctor visits, tests, and services from January 1st onward. Once that total reaches the Part B deductible amount, you have met your deductible for the year.

For Part A, your deductible applies to each benefit period (hospital stay), not the calendar year. If you are admitted to the hospital, you will owe the Part A deductible for that stay. If you are discharged and readmitted within 60 days, you do not owe another deductible. If you are readmitted after 60 days, a new benefit period begins and you owe the deductible again.

Your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) shows what Medicare paid and what you owe. These documents arrive in the mail after you receive care, or you can view them online through your Medicare account at Medicare.gov. Review these documents to track your deductible progress and catch any billing errors.

Frequently Asked Questions

Do I have to pay both the Part A and Part B deductible in the same year?

Yes, if you use both Part A and Part B services in the same year, you will owe both deductibles. They are separate and do not combine. For example, if you have a hospital stay (Part A) and also see your doctor (Part B) in the same calendar year, you owe the Part A deductible for your hospital stay and the Part B deductible for your doctor visits.

What if I only use Part B and never go to the hospital?

You only owe the Part B deductible. The Part A deductible applies only when you are admitted to a hospital, skilled nursing facility, or use certain other Part A services. If you never use Part A services, you never owe the Part A deductible.

Does my deductible reset if I change doctors or hospitals?

No. Your deductible is not tied to any specific provider. All charges from all doctors and hospitals count toward the same deductible. Switching providers does not reset your deductible or require you to pay it again in the same benefit period (Part A) or calendar year (Part B).

Are preventive services subject to the Part B deductible?

Most preventive services covered by Medicare (like annual wellness visits, cancer screenings, and vaccinations) are covered at 100 percent with no deductible or coinsurance. However, if your doctor provides a service beyond the preventive visit — for example, treating a condition discovered during the visit — that additional service may be subject to the deductible and coinsurance.

Can I see my deductible progress online?

Yes. Create an account at Medicare.gov, sign in, and view your claims and deductible status. You can see what Medicare has paid and what you have paid out of pocket. Your MSN or EOB also shows your deductible progress, though these arrive in the mail after services are billed.