Your Part B deductible is a fixed amount you pay out of pocket before Medicare starts to pay for most doctor visits and outpatient services

For 2024, the Part B deductible is $240 per year. Once you have paid $240 in costs for covered services, Medicare begins to cover its share — usually 80 percent — and you pay the remaining 20 percent as coinsurance. The deductible resets on January 1 each year, so any amount you paid in December does not carry over.

The deductible applies to most Part B services: doctor office visits, lab tests, X-rays, and outpatient hospital care. It does not explore to preventive services like annual wellness visits, cancer screenings, or flu shots — those are covered at no cost to you once you meet the deductible or not, depending on the service. Some services, like mental health visits, have their own rules.

If you have a Medigap or Medicare Advantage plan in addition to Original Medicare Part B, that plan may pay your deductible for you. Check your plan documents or call the plan to confirm what they cover.

Key Takeaways

  • The Part B deductible for 2024 is $240 per year and resets every January 1.
  • Once you pay the deductible, Medicare covers 80 percent of most services and you pay 20 percent coinsurance.
  • Preventive services like wellness visits and screenings do not require you to meet the deductible first.
  • A Medigap or Medicare Advantage plan may pay your Part B deductible, so review your plan details.
  • The deductible applies to doctor visits, lab work, imaging, and outpatient hospital services.

How the deductible works with your doctor visits and tests

When you see a doctor or have a lab test, the provider bills Medicare. Medicare determines the approved amount for that service. You are responsible for paying toward your deductible until you reach $240, then Medicare and you share the cost.

For example: your doctor charges $150 for an office visit. Medicare's approved amount is $120. You pay $120 toward your deductible. After you have paid $240 total across all services that year, your next $120 visit means Medicare pays $96 (80 percent) and you pay $24 (20 percent coinsurance).

Keep track of what you have paid toward your deductible. Your Medicare Summary Notice, which arrives quarterly, shows how much you have paid and how much remains. You can also check your deductible status online through your Medicare account at Medicare.gov.

Services that do not count toward your deductible

Preventive services covered by Medicare do not require you to meet the Part B deductible. These include your annual wellness visit, colorectal cancer screening, mammogram, Pap test, prostate screening, and flu, pneumonia, and COVID-19 vaccines. You pay nothing for these services.

Some other services have different cost rules. Home health care, hospice, and dialysis do not use the Part B deductible structure. Durable medical equipment like wheelchairs and oxygen equipment have their own deductible and coinsurance rules. Mental health services may have different cost-sharing.

If you are unsure whether a specific service requires you to meet the deductible, ask your provider before your appointment, or call Medicare at 1-800-MEDICARE to confirm.

When your deductible resets and how to track it

Your Part B deductible resets to zero on January 1 every year. If you paid $180 toward your deductible in November and December, that $180 does not roll over into the new year. You start fresh at $0 on January 1.

Your Medicare Summary Notice shows your deductible progress. This notice arrives in the mail about three weeks after you receive care. It lists each service, what Medicare approved, what you paid, and your remaining deductible balance. If you do not receive a notice, you can view your account online at Medicare.gov or call 1-800-MEDICARE.

Some providers also track this for you and can tell you how much deductible you have left when you call to schedule an appointment. It is worth asking, especially if you are near the end of the year and trying to plan your care.

How supplemental insurance affects your Part B deductible

If you have a Medigap plan (also called Medigap insurance), the plan may pay your Part B deductible for you. Medigap plans are sold by private insurance companies and are designed to cover costs that Original Medicare does not. Some Medigap plans cover the full deductible; others cover part of it. Review your plan's Summary of Benefits or call your Medigap insurer to confirm.

If you have a Medicare Advantage plan instead of Original Medicare, you have a different deductible structure. Medicare Advantage plans set their own deductibles, which may be higher or lower than the Part B deductible, and may explore to different services. Your Medicare Advantage plan documents explain your deductible and how it works.

If you switched from one plan to another during the year, your deductible may not transfer. Check with your new plan about whether any deductible you paid with your old plan counts toward your new plan's deductible.

What to ask your doctor or provider

Before you schedule a service, ask your provider: "What is Medicare's approved amount for this service?" and "Will this count toward my Part B deductible?" Write down the answers. If the provider does not know, ask them to contact Medicare or suggest you call Medicare yourself at 1-800-MEDICARE.

If you receive a bill that seems wrong, compare it to your Medicare Summary Notice. The notice shows what Medicare approved and what you should pay. If the bill does not match, contact the provider's billing department and ask them to explain the difference.

If you have a Medigap or Medicare Advantage plan, also ask your plan whether they will cover the deductible or coinsurance for that specific service. Plans sometimes have exceptions or require prior approval.

When to contact Medicare or your plan

Contact Medicare at 1-800-MEDICARE if you have questions about whether a service counts toward your deductible, what your remaining deductible balance is, or if you believe you were billed incorrectly. You can also create an account at Medicare.gov to view your deductible status online.

Contact your Medigap or Medicare Advantage plan if you are unsure whether they cover your Part B deductible or coinsurance. The plan's customer service number is on your insurance card and in your plan documents.

If you are newly enrolled in Part B and have not yet met your deductible, plan ahead for the year. If you know you will need several services, you may want to schedule them early in the year so you meet the deductible sooner and benefit from the 80/20 cost split for the rest of the year.

Frequently Asked Questions

Does my Part B deductible carry over to the next year if I do not meet it?

No. Any deductible you do not meet by December 31 is lost. On January 1, your deductible resets to zero. If you paid $100 toward your deductible in December, that $100 does not count in the new year.

Do preventive services count toward my deductible?

No. Preventive services like wellness visits, cancer screenings, and vaccines are covered at no cost and do not count toward your Part B deductible. You pay nothing for these services regardless of whether you have met your deductible.

What happens if I have both Original Medicare and a Medicare Advantage plan?

You should have only one Medicare health plan at a time. If you are enrolled in both, contact Medicare to drop one. Medicare Advantage plans have their own deductibles and cost rules that are different from the Part B deductible.

Can I see my deductible balance online?

Yes. Create an account at Medicare.gov and sign in to view your deductible progress. You can also call 1-800-MEDICARE to ask about your balance, or check your Medicare Summary Notice when it arrives in the mail.

Does my Medigap plan always pay my Part B deductible?

Not always. Some Medigap plans cover the full deductible, some cover part of it, and some do not cover it at all. Check your plan's Summary of Benefits or call your Medigap insurer to confirm what they cover.