The Part B deductible is a fixed annual amount you pay before Medicare starts to cover your doctor visits and outpatient services

The Part B deductible is the dollar amount you must pay yourself each calendar year before Medicare begins to pay its share of covered services. Once you meet this deductible, Medicare typically pays 80 percent of approved charges for doctor visits, lab tests, X-rays, and other outpatient care — and you pay the remaining 20 percent, called coinsurance.

The deductible amount changes each year. For 2024, the Part B deductible is $240. For 2025, it is $253. These figures are set by Medicare and announced in the fall of the year before they take effect. The deductible resets on January 1 each year, meaning you start from zero again even if you met it in December.

The deductible applies to most Part B services: doctor office visits, emergency room care, outpatient surgery, diagnostic tests, and durable medical equipment like wheelchairs or oxygen. It does not explore to preventive services such as annual wellness visits, cancer screenings, or flu shots — those are covered at no cost to you once you are enrolled in Part B.

Key Takeaways

  • You pay the full Part B deductible amount yourself before Medicare covers any share of doctor visits or outpatient services.
  • The deductible resets every January 1, so expenses from December do not carry over to the next year.
  • Once you meet the deductible, Medicare pays 80 percent of approved charges and you pay 20 percent coinsurance for most services.
  • Preventive services like wellness visits and screenings have no deductible and are fully covered by Medicare.
  • Medigap or Medicare Advantage plans can cover your deductible, but the rules differ between plan types.

How the deductible works with your other costs

Part B has two separate cost layers: the deductible and coinsurance. You encounter them in order. Until you pay $240 (or $253 in 2025) out of your own pocket, Medicare does not pay anything toward your covered services. Every dollar you spend on a covered service counts toward meeting this deductible.

Once you have paid the deductible, Medicare then covers 80 percent of the approved amount for most services. You pay the remaining 20 percent. This 20 percent payment is called coinsurance and continues for the rest of the year — there is no upper limit on how much coinsurance you might owe.

For example: you see your doctor in January and the approved charge is $150. You pay the full $150 because you have not yet met your deductible. In February, you have lab work done for $200. You pay $90 more to complete your $240 deductible, and Medicare pays $110. From that point forward, you pay 20 percent coinsurance on all covered services for the rest of the year.

Services that do and do not have a deductible

Most doctor and outpatient services require you to meet the Part B deductible first. This includes office visits, specialist consultations, emergency room visits, outpatient surgery, imaging (X-rays, ultrasounds, MRIs), lab tests, and physical therapy.

A significant group of preventive services have no deductible at all. Medicare covers these at no cost to you: annual wellness visits, colorectal cancer screening, mammograms, Pap tests, prostate cancer screening, abdominal aortic aneurysm screening, cardiovascular screening, diabetes screening, bone density testing, and vaccinations (flu, pneumonia, shingles, COVID-19). You do not pay the deductible or coinsurance for these services.

Mental health services and substance use disorder treatment are covered under Part B with the deductible and 20 percent coinsurance, the same as other services. Home health care has no deductible if ordered by your doctor and provided by a Medicare-certified agency, though you may owe coinsurance for some equipment.

How Medigap and Medicare Advantage affect your deductible

If you have a Medigap policy (also called Medigap supplement insurance), the plan you choose determines whether it covers your Part B deductible. Some Medigap plans cover the deductible entirely; others cover it partially; some do not cover it at all. Plan G, for instance, covers the Part B deductible in full. Plan N covers it partially. Plan A does not cover it. You need to check your specific plan documents to know what your plan covers.

If you have Medicare Advantage (Part C), you do not have the same Part B deductible. Instead, Medicare Advantage plans set their own deductibles, which may be higher, lower, or zero depending on the plan. Some Medicare Advantage plans have no deductible at all for in-network care. Others have a deductible that applies only to certain types of services. You pay what your specific plan requires, not the standard Part B deductible.

If you have employer or union coverage in addition to Medicare, that coverage may pay your Part B deductible. You should contact your employer's benefits office to learn what your group plan covers.

Tracking your deductible throughout the year

You are responsible for keeping track of what you have paid toward your deductible. Medicare does not send you a notice when you have met it. Your provider's billing office may tell you whether your deductible has been satisfied, but it is wise to track it yourself.

When you receive a bill or explanation of benefits (EOB) from Medicare, look for the line that shows how much of your payment counted toward the deductible. Save these documents. If you see multiple providers, keep a running total of deductible payments across all of them.

You can also call Medicare at 1-800-MEDICARE (1-800-633-4227) and ask whether your deductible has been met. Have your Medicare number ready. They can tell you the total amount you have paid toward your deductible so far in the calendar year.

What happens if you do not meet your deductible by year-end

If you do not use enough medical services to reach your deductible by December 31, the unused portion straightforward disappears. You do not carry it forward to the next year. On January 1, your deductible resets to the new year's amount, and you start from zero again.

This is one reason some people with predictable medical needs try to schedule services before year-end if they are close to meeting their deductible. Once you have paid it, the 80/20 split means you pay less out of pocket for additional services that year. However, you should never delay necessary medical care just to meet a deductible.

Frequently Asked Questions

Does the Part B deductible explore to prescription drugs?

No. Prescription drugs are covered under Part D, which has its own separate deductible. The Part B deductible applies only to doctor visits and outpatient services. If you take prescription medications, you will have both a Part B deductible and a Part D deductible to manage.

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

Your deductible does not transfer between plan types. If you have paid part of your Part B deductible under Original Medicare and then switch to a Medicare Advantage plan, you start fresh with your new plan's deductible rules. Any amount you paid toward the Original Medicare deductible does not count toward your Medicare Advantage deductible.

Do I pay the Part B deductible for emergency room visits?

Yes. Emergency room visits are covered under Part B and subject to the deductible and 20 percent coinsurance. However, if the emergency room visit leads to an inpatient hospital stay, the ER charges may be bundled into your hospital bill, which falls under Part A instead and has different cost rules.

Can I pay my Part B deductible all at once to get it over with?

No. You cannot prepay the deductible. You pay it only as you use covered services throughout the year. The deductible is met by the actual charges you incur for covered care, not by a lump-sum payment.

Does my Part B deductible reset if I move to a different state?

No. Your Part B deductible is tied to the calendar year, not your location. If you move in June, your deductible does not reset. You continue counting toward the same $240 (or $253 in 2025) deductible for the rest of that calendar year, regardless of which state you live in.