A Medicare deductible is the amount you must pay for healthcare services before Medicare starts to pay its share

Each part of Medicare has its own deductible. Part A (hospital insurance) has one deductible per benefit period — currently $1,676 for 2024, though this amount changes each year. Part B (medical insurance) has a separate deductible of $240 for 2024. Part D (prescription drug coverage) has its own deductible that varies by plan, usually between $0 and $505. If you have a Medigap or Medicare Advantage plan, you may have different deductibles depending on which plan you chose.

The key difference between parts: with Part A, you pay the deductible once per benefit period (a hospital stay counts as one benefit period, even if you stay multiple times within 60 days). With Part B, you pay the deductible once per calendar year. With Part D, the deductible resets every January 1st. After you meet the deductible, Medicare pays its portion and you typically pay a copay or coinsurance for each service.

Key Takeaways

  • Part A deductible applies once per benefit period for hospital stays; Part B deductible applies once per calendar year for doctor visits and outpatient care.
  • Part D deductible varies by prescription drug plan and resets every January, ranging from $0 to $505 in 2024.
  • After you meet your deductible, you still pay copays or coinsurance — the deductible is not your only out-of-pocket cost.
  • Medicare Advantage and Medigap plans have their own deductible structures that may be lower or higher than Original Medicare.
  • Deductible amounts increase each year; you can find the current year's amounts on Medicare.gov or your plan documents.

How Part A deductible works 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 before Medicare begins to pay. If you are discharged and readmitted within 60 days of your previous discharge, you do not pay the deductible again — you are still in the same benefit period. However, if you are readmitted more than 60 days after discharge, a new benefit period begins and you owe the deductible again.

After you pay the deductible, Medicare covers all approved hospital costs for days 1 through 60 of your stay. On days 61 through 90, you pay a daily coinsurance amount (currently $419 per day in 2024). If you stay longer than 90 days, you enter your "lifetime reserve days" — 60 additional days that Medicare will cover if you use them, but you pay coinsurance for each of those days too.

How Part B deductible works for doctor visits and outpatient care

Part B covers doctor visits, outpatient surgery, diagnostic tests, and durable medical equipment. You pay the Part B deductible once per calendar year before Medicare starts paying. Unlike Part A, the deductible does not reset based on benefit periods — it resets on January 1st every year, regardless of when you used services.

Once you meet the Part B deductible, Medicare typically pays 80 percent of approved charges for most services, and you pay 20 percent coinsurance. Some preventive services (like annual wellness visits and cancer screenings) have no coinsurance after the deductible is met. Your doctor's office can tell you whether a specific service counts as preventive or if you will owe coinsurance.

How Part D deductible works for prescription drugs

Part D deductibles vary significantly depending on which drug plan you choose. Some plans have no deductible at all, while others charge up to $505 in 2024. You pay the deductible before the plan begins to pay for your prescriptions. After you meet it, you typically pay a copay for each prescription (a fixed dollar amount) or coinsurance (a percentage of the drug cost), depending on the plan and the drug tier.

Part D has an additional cost structure called the "donut hole" or coverage gap. Once you and your plan have spent a combined $4,850 in 2024, you enter the coverage gap and pay a higher percentage of drug costs until your out-of-pocket spending reaches $7,050. After that, catastrophic coverage kicks in and you pay only a small copay. The exact amounts change each year.

Medicare Advantage and Medigap deductibles are different

If you chose a Medicare Advantage plan (Part C), you have a different deductible structure than Original Medicare. Some Medicare Advantage plans have no deductible, while others have deductibles that can be higher than Original Medicare. The plan documents you received when you enrolled will show your specific deductible. Many Medicare Advantage plans also include Part D drug coverage with its own deductible built in.

Medigap plans (supplemental insurance) work differently — they do not have deductibles in the traditional sense. Instead, you pay a monthly premium for the Medigap plan, and then the plan covers some or all of the coinsurance and copays you would owe under Original Medicare. The Medigap plan letter (A, B, D, G, etc.) determines what it covers. For example, Plan G covers your Part B deductible, while Plan N does not.

When deductibles reset and how to track them

Part A deductible resets when a new benefit period begins — 60 days after you are discharged from a hospital or skilled nursing facility. Part B deductible resets on January 1st every year. Part D deductible resets on January 1st every year. If you have a Medicare Advantage plan, check your plan documents for when deductibles reset, as some plans may have different timing.

You can track your deductible progress by logging into your Medicare account at Medicare.gov or by calling your plan directly. Your Explanation of Benefits (EOB) statement, which you receive after each service, shows how much of your deductible you have met. Keep these statements so you know when you have reached your deductible and can stop paying it for the rest of the year.

Questions to ask your doctor or plan about deductibles

Before you schedule a service or fill a prescription, ask your doctor's office or pharmacy whether the service counts toward your deductible and what you will owe. Ask whether the provider is in-network with your plan, because out-of-network providers may have different deductibles or may not be covered at all. If you are considering a procedure, ask the office to estimate your total out-of-pocket cost, including the deductible and any coinsurance.

If you are unsure whether you have met your deductible, call your plan's customer service number (on your insurance card) and ask for your deductible status. They can tell you exactly how much you have paid toward the deductible and how much remains. This information is also available in your online account on Medicare.gov or your plan's website.

Frequently Asked Questions

Do I have to pay my deductible every year?

Yes. Part B and Part D deductibles reset every January 1st, so you pay them once per calendar year. Part A deductible resets when a new benefit period begins, which happens 60 days after you leave the hospital or skilled nursing facility. If you do not use hospital services, you may not pay a Part A deductible in a given year.

What happens if I switch Medicare plans mid-year?

If you switch to a new plan, you may have a new deductible. Any deductible you already paid toward your old plan does not transfer to the new plan. For example, if you switched Part D plans in June and had already paid $200 toward your old plan's deductible, you start over with the new plan's deductible. This is one reason to carefully consider switching plans only during the annual enrollment period.

Can I get help paying my deductible if I have low income?

You may be able to get help through programs like the Medicare Savings Program or Extra Help (for Part D). These programs are run by your state and can pay some or all of your deductible and other out-of-pocket costs. Contact your state Medicaid office or call 1-800-MEDICARE to learn whether you may be may be able to access for these programs.

Does my Medigap plan cover my deductible?

It depends on which Medigap plan you have. Plan G covers your Part B deductible, but Plan N does not. Most Medigap plans cover your coinsurance and copays after you meet the deductible, which means you pay less out of pocket overall. Review your plan documents or call your Medigap insurer to confirm what your specific plan covers.

Why do Medicare deductibles increase every year?

Medicare deductibles are adjusted annually based on changes in healthcare costs and program expenses. The Centers for Medicare and Medicaid Services (CMS) announces the new deductible amounts in the fall, and they take effect on January 1st. This means you should check Medicare.gov each October or November to see what your deductibles will be for the coming year.