What You Pay Out of Pocket for Medicare Part A and Part B

The Basic Deductible: What You Owe Before Medicare Pays

A deductible is the amount you pay for healthcare services before Medicare starts to pay its share. Medicare Part A and Part B each have their own separate deductibles, and they work differently from each other.

For Part A (hospital insurance), you pay a single deductible per benefit period — not per year. A benefit period starts the day you enter a hospital and ends 60 days after you leave without being readmitted. If you go back into the hospital after those 60 days, a new benefit period begins and you owe a new deductible.

For Part B (medical insurance), you pay an annual deductible once per calendar year. After you meet it, Medicare covers its share of most services for the rest of that year. The deductible amounts change each January and are set by Medicare based on inflation.

Key Takeaways

Part A has a deductible per hospital stay (or benefit period), while Part B has an annual deductible that resets every January.
The Part A deductible covers your first day in the hospital; after that, you pay a daily copay for days 2 through 60, then higher copays for days 61 and beyond.
Once you meet your Part B deductible, Medicare pays 80 percent of most doctor visits and outpatient services, and you pay 20 percent.
Deductible amounts change yearly and are published by Medicare in the fall before they take effect.
If you have a Medigap or Medicare Advantage plan, that plan may cover some or all of your deductibles.

How Part A Deductible Works in a Hospital Stay

When you are admitted to a hospital, you pay the Part A deductible for days 1 through 3. This is a one-time payment per benefit period, regardless of how many days you stay. After you pay the deductible, Medicare covers all hospital costs for days 4 through 60.

On days 61 through 90, you pay a daily copay (a fixed dollar amount per day) while Medicare covers the rest. If you stay longer than 90 days, you enter what Medicare calls "lifetime reserve days" — you have 60 of these over your entire lifetime, and you pay a higher daily copay for each one you use.

Once a benefit period ends (60 days after discharge), any days you already paid for do not count toward a future deductible. If you return to the hospital after that 60-day window, you start a new benefit period and owe a new deductible.

How Part B Deductible Works for Doctor and Outpatient Care

The Part B deductible applies to most doctor visits, lab tests, imaging, and outpatient procedures. You pay the full cost of these services until you reach the deductible amount. Once you meet it in a calendar year, Medicare pays 80 percent of the approved amount for most services, and you pay the remaining 20 percent (called coinsurance).

Some Part B services do not count toward your deductible. These include preventive care visits (like annual wellness exams and cancer screenings), which Medicare covers at no cost to you. Other services, like mental health visits, may have different cost-sharing rules even after you meet your deductible.

Your Part B deductible resets to zero on January 1 each year, so any progress you made toward it in December does not carry over.

When Your Deductible Amounts Change

Medicare announces new deductible amounts in the fall, and they take effect on January 1. The amounts are tied to inflation and medical cost trends, so they typically increase each year, though the amount of increase varies.

You can find the current year's deductible amounts on Medicare.gov, or you can call Medicare at 1-800-MEDICARE (1-800-633-4227) to ask. Your Medicare card will also list your deductible amounts, though it may take a few weeks after January 1 for the card to reflect the new year's figures.

How Medigap and Medicare Advantage Plans Affect Your Deductible

If you have a Medigap plan (supplemental insurance), that plan may pay some or all of your Part A and Part B deductibles. The amount covered depends on which Medigap plan you choose — some plans cover the full deductible, others cover part of it, and a few cover none of it. Your Medigap policy documents will show exactly what it covers.

If you have a Medicare Advantage plan (Part C), you have a different deductible structure altogether. These plans set their own deductibles, which may be higher, lower, or the same as Original Medicare. Some Medicare Advantage plans have no deductible at all. You should review your plan's Summary of Benefits each year to see what you will owe.

What to Ask Your Doctor or Medicare

Before a hospital stay or expensive outpatient procedure, ask your doctor's office whether the service is covered by Medicare and what your out-of-pocket cost will be. They can tell you whether the service counts toward your deductible or whether it is a preventive service covered at no cost.

If you are unsure whether you have met your Part B deductible for the year, you can check your Medicare Summary Notice (the statement Medicare sends you quarterly) or log into your Medicare account at Medicare.gov. You can also call 1-800-MEDICARE to ask.

When to Seek Help Understanding Your Costs

If you receive a bill that seems wrong, or if you are unsure whether you should have been charged, contact the provider's billing office first. Ask them to explain which deductible or copay the charge is for and whether it has been applied correctly.

If you still disagree with the bill, you can file an appeal with Medicare. Your Medicare Summary Notice includes instructions on how to appeal. You can also contact your State Health Insurance information Program (SHIP), which offers free counseling about Medicare costs — find your state's program at shiptalk.org or by calling 1-800-MEDICARE.

Frequently Asked Questions

Do Part A and Part B deductibles count toward each other?

No. They are completely separate. Money you pay toward your Part A deductible does not reduce what you owe for your Part B deductible, and vice versa. You must meet each deductible independently.

What happens if I have a hospital stay that spans two calendar years?

You pay the Part A deductible for the benefit period in which you were admitted, regardless of when you are discharged. The calendar year does not matter for Part A — only the benefit period does. Part B deductibles, however, always reset on January 1.

If I have Medicare Advantage, do I still have a Part A and Part B deductible?

No. Medicare Advantage plans replace Original Medicare, so you do not pay the Original Medicare deductibles. Instead, your plan sets its own deductible, which may be different. Check your plan documents to see what you owe.

Can I pay my deductible in installments instead of all at once?

That depends on the provider. Hospitals and doctors' offices may offer payment plans if you ask, but Medicare itself does not set up installment arrangements. Contact your provider's billing department to discuss options.

Are there any Part B services that do not require me to meet the deductible first?

Yes. Preventive services like annual wellness visits, cancer screenings, and certain vaccines are covered at no cost and do not count toward your deductible. Mental health services, dialysis, and some other services also have different rules — check Medicare.gov or call 1-800-MEDICARE for specifics.

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.