Your Medicare deductible is the amount you pay out of your own pocket before Medicare starts to pay its share

Medicare has different deductibles depending on which part of coverage you use. Part A (hospital care) has one deductible per benefit period. Part B (doctor visits and outpatient care) has a separate annual deductible. Part D (prescription drugs) has its own deductible that resets each year. If you have a Medigap or Medicare Advantage plan instead of Original Medicare, your deductible may be different or may not exist at all.

The deductible amounts change each year. The Centers for Medicare & Medicaid Services (CMS) sets new amounts every January based on healthcare cost trends. This means the number you paid last year may not be the number you pay this year.

Key Takeaways

  • Part A has a deductible per benefit period (not per year), which covers up to 60 days of hospital care, and the amount varies by year.
  • Part B has an annual deductible that you pay once per calendar year before Medicare covers doctor visits and outpatient services.
  • Part D prescription drug deductibles vary by plan and can range from zero to several hundred dollars depending on which plan you choose.
  • Medicare Advantage and Medigap plans set their own deductibles, which are often lower or zero compared to Original Medicare.
  • You can find the current year's deductible amounts on Medicare.gov or by calling 1-800-MEDICARE.

Part A deductible: what it covers and how long it lasts

Part A covers hospital stays, skilled nursing facility care, hospice, and home health services. The deductible applies per benefit period, not per calendar year. A benefit period starts the day you enter the hospital and ends 60 days after you leave without receiving any hospital or skilled nursing care. If you go back to the hospital after that 60-day break, a new benefit period begins and you pay the deductible again.

This means you could pay the Part A deductible more than once in a single calendar year if you have multiple hospital stays separated by at least 60 days. You could also pay it only once if all your hospital care happens within a single benefit period, even if that spans two calendar years.

After you pay the Part A deductible, Medicare covers all covered hospital costs for days 1 through 60 of your stay. For days 61 through 90, you pay a daily coinsurance amount (a set dollar amount per day, not a percentage). Beyond 90 days, costs rise further, and Medicare's coverage becomes limited.

Part B deductible: annual and straightforward

Part B covers doctor visits, outpatient surgery, diagnostic tests, and other outpatient services. The deductible is annual, meaning it resets on January 1 each year. Once you pay it, Medicare covers 80 percent of approved services, and you pay the remaining 20 percent as coinsurance.

The Part B deductible applies to most services, but some preventive care (like annual wellness visits and certain screenings) has no deductible. You pay the deductible only once per year, even if you see multiple doctors or have multiple tests.

Part D deductible: varies by prescription drug plan

Part D covers prescription medications through private insurance plans that contract with Medicare. Each plan sets its own deductible, which can range from zero to several hundred dollars per year. Some plans have no deductible at all, while others require you to pay the full cost of medications until you reach the deductible amount.

After you meet the deductible, you typically pay a fixed copay or coinsurance for each prescription, depending on the plan's design. The deductible resets on January 1 each year. If you switch plans during the annual enrollment period, your new plan's deductible begins fresh in January.

How deductibles work differently in Medicare Advantage and Medigap plans

Medicare Advantage plans (Part C) combine Part A, Part B, and usually Part D coverage under one plan run by a private insurer. These plans set their own deductibles, which are often lower than Original Medicare or may be zero. Some Advantage plans have no deductible at all for certain services. However, they may have higher copays or coinsurance for specific services, and they often include network restrictions.

Medigap plans (supplemental insurance) work alongside Original Medicare. They help pay the deductibles, coinsurance, and copays that Medicare does not cover. Depending on which Medigap plan you choose (Plan A through Plan N), your out-of-pocket costs vary. Some Medigap plans cover the Part B deductible entirely, while others do not.

Current deductible amounts and where to find them

Deductible amounts are set by CMS and announced in the fall for the following year. You can find the current year's amounts on Medicare.gov under the "Costs" section, or you can call 1-800-MEDICARE (1-800-633-4227) to speak with a representative. The website also shows deductibles for specific Medicare Advantage and Part D plans in your area.

If you are enrolled in a Medigap or Medicare Advantage plan, your plan's member handbook or annual notice of changes will show your specific deductible. These documents are mailed to you each fall before the new year begins.

What happens if you cannot afford to pay your deductible

If paying the deductible creates a hardship, talk to your doctor's office or hospital billing department. Many providers offer payment plans that let you spread the cost over several months rather than paying it all at once. Some hospitals have financial information programs for uninsured or underinsured patients, and you may be able to negotiate a reduced rate.

If you have limited income, you may be may be able to access for programs like Medicaid (which varies by state) or Medicare Savings Programs, which help pay Medicare premiums and deductibles. Your local Area Agency on Aging or a 211 referral can connect you with these programs in your area.

Frequently Asked Questions

Do I pay my deductible every month?

No. Part B and Part D deductibles are annual, meaning you pay them once per calendar year. Part A deductible is per benefit period, not per month. Once you meet your deductible, you do not pay it again until the next year (or the next benefit period for Part A).

If I have both Part A and Part B, do I pay two separate deductibles?

Yes. Part A and Part B have separate deductibles. You pay one for hospital care and a different one for doctor visits and outpatient services. If you also have Part D, that is a third deductible.

What is the difference between a deductible and coinsurance?

A deductible is what you pay before Medicare starts covering costs. Coinsurance is what you pay after the deductible is met — usually a percentage (like 20 percent) or a fixed dollar amount per day. You may pay both in the same year.

Can my deductible change mid-year?

No. Deductibles are set on January 1 and do not change until the following year. If you switch plans during the annual enrollment period (October 15 to December 7), your new plan's deductible takes effect on January 1.

Does preventive care have a deductible?

Most preventive services covered by Medicare (like annual wellness visits, cancer screenings, and vaccines) have no deductible. You pay nothing for these services. However, if your visit includes other care beyond prevention, you may owe a deductible for that portion.