What Medicare deductibles are and how they work in 2025

A deductible is the amount you pay out of your own pocket before Medicare starts to pay its share. Medicare has different deductibles for different parts of the program, and those amounts change each year. For 2025, the deductibles are higher than they were in 2024, and they vary depending on which part of Medicare you use.

The deductible applies once per calendar year. Once you have paid the full deductible amount for a particular part of Medicare, that program begins to cover its portion of your costs for the rest of that year. The deductible resets on January 1 each year.

Understanding which deductible applies to you depends on which Medicare services you are using. Hospital stays, doctor visits, and prescription drugs each have their own deductible structure, and some people will pay multiple deductibles in a single year.

Key Takeaways

  • Medicare Part A (hospital insurance) has a deductible of $1,676 per benefit period in 2025, which covers a hospital stay and related care.
  • Medicare Part B (doctor visits and outpatient care) has a deductible of $240 per year in 2025, after which Medicare covers 80 percent of approved services.
  • Medicare Part D (prescription drugs) deductibles vary by plan but can be up to $545 per year in 2025, depending on which drug plan you choose.
  • Medigap and Medicare Advantage plans have their own deductibles and cost structures that may be different from Original Medicare.
  • Your actual out-of-pocket costs depend on which type of Medicare coverage you have and which services you use during the year.

Medicare Part A deductible for hospital stays

Part A covers inpatient hospital care, skilled nursing facility care, hospice, and home health services. The Part A deductible for 2025 is $1,676 per benefit period. A benefit period begins when you enter the hospital and ends after you have been out of the hospital or skilled nursing facility for 60 consecutive days.

If you are hospitalized more than once in the same year, you may pay the deductible more than once. Each new hospital stay that begins after your previous benefit period has ended counts as a new benefit period with its own deductible. However, if you return to the hospital within 60 days of leaving, it is considered part of the same benefit period and you do not pay another deductible.

After you pay the Part A deductible, Medicare covers all approved hospital costs for days 1 through 60 of your hospital stay. For days 61 through 90, you pay a daily coinsurance amount (not a deductible). For days beyond 90, costs are higher. Home health services and hospice have no deductible under Part A.

Medicare Part B deductible for doctor visits and outpatient services

Part B covers doctor visits, outpatient care, medical equipment, and preventive services. The Part B deductible for 2025 is $240 per year. You pay this deductible once each calendar year, and it applies to all Part B services except preventive care.

Preventive services such as annual wellness visits, cancer screenings, and vaccinations have no deductible. Once you have paid the $240 deductible, Medicare covers 80 percent of the approved amount for most Part B services, and you pay the remaining 20 percent as coinsurance.

The Part B deductible is separate from the Part A deductible. If you use both hospital services and doctor services in the same year, you will pay both deductibles unless you have Medigap or Medicare Advantage coverage that combines or reduces them.

Medicare Part D deductible for prescription drugs

Part D covers prescription medications through private insurance plans. The deductible for Part D varies by plan and is set by each insurance company, but cannot exceed $545 per year in 2025. Some plans have no deductible at all, while others charge the maximum amount.

Once you pay your plan's deductible, you enter the "initial coverage phase," where you and your plan share the cost of drugs. The amount you pay depends on your plan's formulary (the list of covered drugs) and whether the drug is generic or brand-name.

Part D deductibles reset on January 1 each year. If you switch plans during the annual enrollment period (October 15 to December 7), your new plan's deductible begins on January 1, even if you have not yet met your old plan's deductible.

How deductibles work with Medigap and Medicare Advantage plans

If you have Medigap (supplemental insurance), your Medigap plan may pay some or all of your Medicare deductibles, depending on which Medigap plan you choose. Some Medigap plans cover the Part A deductible, the Part B deductible, or both. You will still pay your Medigap premium, but the deductible burden may be lower.

Medicare Advantage plans (Part C) replace Original Medicare and have their own deductible structure. These plans often have lower or no deductibles than Original Medicare, but they typically have higher copays or coinsurance for individual services. Medicare Advantage plans also usually include Part D drug coverage built in, with its own deductible.

If you switch from Original Medicare to Medicare Advantage or vice versa, your deductible resets on January 1. Deductibles paid under one plan do not carry over to another plan.

Tracking your deductible throughout the year

You are responsible for keeping track of how much you have paid toward your deductible. Medicare sends you an Explanation of Benefits (EOB) after each service, which shows what you paid and what counts toward your deductible. Your doctor's office or hospital billing department can also tell you whether a specific service counts toward your deductible.

For Part D, your pharmacy or insurance company can tell you how much of your deductible you have met. Many insurance companies also offer online portals or phone lines where you can check your deductible status at any time during the year.

Keep copies of your EOBs and receipts in case you need to dispute a charge or verify that you have met your deductible. If you believe a service should have counted toward your deductible and was not credited, contact your Medicare plan or provider when ready.

Frequently Asked Questions

Do I have to pay all my deductibles at once?

No. You pay your deductible gradually as you receive services throughout the year. Each time you receive a covered service, the amount you pay counts toward your deductible until you reach the full amount. Once you have paid the full deductible, Medicare begins to cover its share.

What happens if I do not meet my deductible by the end of the year?

If you do not reach your deductible by December 31, the unused amount does not carry over to the next year. Your deductible resets to zero on January 1, and you start over. This is why some people choose to delay elective procedures until after their deductible has been met.

Are preventive services subject to the deductible?

No. Medicare Part B covers certain preventive services with no deductible and no coinsurance, including annual wellness visits, cancer screenings, and flu shots. However, if you receive a service that is not on the preventive list, the Part B deductible applies.

Can I use my Health Savings Account to pay my Medicare deductible?

Once you enroll in Medicare, you can no longer contribute to a Health Savings Account (HSA). However, you can use money already in your HSA to pay Medicare deductibles and other out-of-pocket costs. Withdrawals for Medicare expenses are not subject to the 20 percent penalty that normally applies to non-medical HSA withdrawals.

Do deductibles explore if I have both Medicare and Medicaid?

If you have both Medicare and Medicaid (called "dual may be able to access"), Medicaid may pay your Medicare deductibles and coinsurance. The rules vary by state. Contact your state Medicaid office or your local Area Agency on Aging to learn what Medicaid covers in your situation.