Medicare has different deductibles for each part, and they change every year

Medicare's deductible is the amount you pay out of your own pocket before Medicare starts to pay its share. The deductible is not the same across all of Medicare — Part A (hospital care), Part B (doctor visits and outpatient care), and Part D (prescription drugs) each have their own separate deductible. Part C (Medicare Advantage) sets its own deductible, which varies by plan.

The deductible amounts increase each year. For 2024, Part A's deductible is $1,632 per benefit period, Part B's is $240 per year, and Part D deductibles vary by plan but cannot exceed $505. These numbers change annually, so the amount you owe this year will not be the same next year. Your Medicare Summary Notice (the document Medicare sends you each year) shows your current deductible.

Key Takeaways

  • Part A covers hospital stays and has a deductible per benefit period (a new benefit period starts 60 days after you leave the hospital).
  • Part B covers doctor visits and outpatient services and has a yearly deductible that resets on January 1st.
  • Part D prescription drug coverage has a deductible that varies by plan, and you pay it before your plan starts to cover most drugs.
  • Once you meet your deductible, you still pay coinsurance or copayments — the deductible is not your only out-of-pocket cost.
  • Deductible amounts increase each year, so check your Medicare documents annually to see what you owe.

How Part A deductibles work for hospital stays

Part A covers inpatient hospital care, skilled nursing facility care, hospice, and home health services. The Part A deductible applies per benefit period, not per year. A benefit period begins the day you enter the hospital and ends 60 days after you leave. If you go back into the hospital more than 60 days later, a new benefit period starts and you owe a new deductible.

Once you pay the Part A deductible, Medicare covers all covered hospital costs for days 1 through 60 of your hospital stay. For days 61 through 90, you pay a daily coinsurance amount. After day 90, you can use your lifetime reserve days (which are limited), and you pay a higher daily coinsurance. This means the deductible is just your first payment — additional costs follow depending on how long you stay.

How Part B deductibles work for doctor and outpatient care

Part B covers doctor visits, outpatient surgery, diagnostic tests, and other outpatient services. The Part B deductible is yearly and resets on January 1st each year. You pay this deductible once per calendar year, no matter how many doctors you see or how many services you receive.

After you meet your Part B deductible, you typically pay 20 percent coinsurance for most services, and Medicare pays 80 percent. Some preventive services (like annual wellness visits and certain screenings) have no deductible and no coinsurance — Medicare covers them fully. Your doctor's office can tell you whether a specific service requires you to meet your deductible first.

How Part D deductibles work for prescription drugs

Part D is prescription drug coverage offered through private insurance companies approved by Medicare. Each plan sets its own deductible, and it can range from zero to the maximum amount (which changes yearly). Some plans have no deductible at all, while others require you to pay several hundred dollars before the plan covers your drugs.

Once you pay your Part D deductible, you move into the initial coverage stage, where you and your plan share the cost of drugs. You pay a copayment or coinsurance for each prescription. The deductible applies to most drugs but not all — some plans cover certain drugs (often generics or preventive medications) before you meet your deductible. Your plan's formulary (the list of covered drugs) shows which drugs require you to meet the deductible first.

What happens after you meet your deductible

Meeting your deductible does not mean Medicare covers everything after that point. You still pay coinsurance (a percentage of the cost) or copayments (a fixed dollar amount per visit or prescription) depending on the service and which part of Medicare covers it.

Part B also has an annual out-of-pocket maximum called the Part B out-of-pocket threshold. Once your coinsurance and copayments for Part B services reach this amount in a calendar year, Medicare covers 100 percent of your remaining Part B costs for the rest of that year. Part D has a similar structure: after you pay your deductible and move through the initial coverage stage, you may enter a coverage gap (sometimes called the "donut hole"), where you pay a higher percentage of drug costs until you reach catastrophic coverage.

How to find your current deductible amounts

Your Medicare Summary Notice, sent to you by mail each year, lists your current deductible for each part. You can also log into your Medicare account at Medicare.gov to view your deductible information. If you have a Medicare Advantage plan (Part C), your plan's member handbook or your plan's website shows your deductible.

If you have a Medigap (supplemental insurance) policy, that policy may cover some or all of your Medicare deductibles and coinsurance, depending on which Medigap plan you chose. Check your Medigap policy documents to see what out-of-pocket costs your supplemental coverage pays.

Deductibles for Medicare Advantage plans

Medicare Advantage plans (Part C) are an alternative to Original Medicare. These plans are run by private insurance companies and must cover everything Original Medicare covers, but they set their own deductibles, copayments, and coinsurance. Some Medicare Advantage plans have zero deductible, while others have deductibles similar to or higher than Original Medicare.

Because each Medicare Advantage plan is different, you need to check the specific plan's documents to learn its deductible. During the Annual Enrollment Period (October 15 through December 7 each year), you can compare plans side by side on Medicare.gov to see which deductible and out-of-pocket costs work best for your situation.

Frequently Asked Questions

Do I have to pay my deductible every year?

Yes. Part B and Part D deductibles reset on January 1st each year, so you pay them annually. Part A deductibles reset when a new benefit period begins (60 days after you leave the hospital), not on a calendar year. If you do not use hospital services, you may not owe a Part A deductible in a given year.

What if I have both Original Medicare and a Medigap policy?

Medigap policies are designed to cover some or all of your Original Medicare deductibles and coinsurance. Which costs your Medigap covers depends on which Medigap plan (A through N) you chose. Check your Medigap policy documents or call your Medigap insurance company to see what deductibles and coinsurance your plan covers.

Can I see my deductible information online?

Yes. Log into your account at Medicare.gov with your username and password. You can also call Medicare at 1-800-MEDICARE (1-800-633-4227) to ask about your current deductible amounts. If you have a Medicare Advantage plan, your plan's website or member services phone number can provide your deductible details.

What if I switch Medicare plans during the year?

If you switch from Original Medicare to a Medicare Advantage plan (or vice versa) during the year, your deductibles do not carry over. You start fresh with your new plan's deductible. Any deductible you already paid toward your old plan does not count toward your new plan's deductible.