The Medicare Part B Deductible Explained

The Medicare Part B deductible is a fixed dollar amount you must pay out of your own pocket each year before Medicare starts to pay for most doctor visits, outpatient services, and medical equipment. For 2024, that amount is $240. Once you have paid $240 in covered services, Medicare covers 80 percent of the approved cost for most services for the rest of that calendar year, and you pay the remaining 20 percent as coinsurance.

The deductible resets on January 1 each year, meaning you start over at zero every January. It applies only to Part B services — hospital stays are covered under Part A and have a separate deductible. The Part B deductible does not explore to preventive services like annual wellness visits, cancer screenings, or vaccinations; those are covered at no cost to you once you meet the deductible for other services.

Key Takeaways

  • You must pay $240 out of pocket in 2024 before Medicare begins to cover 80 percent of Part B services.
  • The deductible covers doctor visits, lab work, imaging, and most outpatient care — but not preventive screenings, which are free.
  • Once you meet the deductible, you pay 20 percent coinsurance on covered services for the rest of the calendar year.
  • The deductible amount changes each year and is set by Medicare; check the current year's amount on Medicare.gov before your first visit.

How the Deductible Works in Practice

Imagine you see your doctor in January and the approved cost is $150. You pay the full $150 toward your deductible. In February, you have lab work done that costs $120. You pay $120 more, bringing your total to $270. You have now met your $240 deductible and paid $30 extra.

From that point forward in 2024, Medicare pays 80 percent of approved costs and you pay 20 percent coinsurance. If you need an MRI that costs $1,000, Medicare pays $800 and you pay $200. This continues through December 31. On January 1, 2025, your deductible resets to zero and the cycle begins again.

The deductible applies to the approved amount Medicare sets, not the actual bill your doctor sends. If your doctor charges $300 but Medicare's approved amount is $200, only the $200 counts toward your deductible. This is why it matters to see doctors who accept Medicare assignment — they agree to bill only the approved amount.

Services Covered and Not Covered by the Deductible

The Part B deductible applies to most doctor visits, specialist consultations, lab tests, X-rays, ultrasounds, CT scans, and durable medical equipment like wheelchairs or oxygen. It also applies to mental health visits, physical therapy, and outpatient surgery. Essentially, if it is a Part B service and it is not preventive, the deductible applies.

Preventive services are exempt from the deductible. These include your annual wellness visit, cancer screenings (mammograms, colonoscopies, Pap smears), bone density tests, cardiovascular screenings, diabetes screenings, and all recommended vaccinations. You pay nothing for these services, even before you meet your deductible. Emergency room visits are covered under Part A (hospital insurance), not Part B, so they have a different cost structure.

What Happens If You Have Supplemental or Advantage Coverage

If you have a Medigap policy (supplemental insurance), the plan you chose determines whether it pays your Part B deductible. Some Medigap plans cover the full deductible; others cover part of it; some cover none. You need to check your specific plan documents or call your Medigap insurer to know what they cover.

If you have a Medicare Advantage plan instead of Original Medicare, you do not have a Part B deductible in the traditional sense. Advantage plans set their own cost structure — they may have a different deductible, copays, or coinsurance amounts. Your Advantage plan documents will show what you pay for each type of service.

The Deductible Amount Changes Each Year

Medicare adjusts the Part B deductible annually based on changes in healthcare costs. The 2024 amount is $240, but this may be different in 2025 or beyond. The new deductible amount is announced in the fall of each year and takes effect on January 1. You can find the current year's deductible on Medicare.gov or by calling Medicare at 1-800-MEDICARE.

The deductible has risen significantly over the past decade, so it is worth checking the current amount before your first visit of the year. Some people schedule their annual wellness visit in late December to use it before the deductible resets, though this strategy only works if you have already met the deductible for that year.

How to Track Your Deductible Throughout the Year

You are responsible for keeping track of what you have paid toward your deductible. Medicare sends you an Explanation of Benefits (EOB) after each service showing the approved amount, what you paid, and what Medicare paid. Keep these documents and add up your out-of-pocket costs as the year goes on.

You can also check your deductible status online through your Medicare account at Medicare.gov. Log in, go to "Claims," and you will see a summary of what you have paid toward your deductible and out-of-pocket maximum for the year. If you use the same doctor or clinic regularly, ask the billing office to track it for you — many offices keep records of patient deductible status.

The Part B Out-of-Pocket Maximum

Once you have paid the deductible and 20 percent coinsurance on enough services to reach the out-of-pocket maximum, Medicare covers 100 percent of approved costs for the rest of the year. For 2024, the out-of-pocket maximum is $2,000. This means that once you have paid $240 in deductible plus $1,760 in coinsurance, Medicare covers everything else at no cost to you.

This maximum protects you from unlimited medical bills in a single year. However, it resets on January 1, just like the deductible. If you have a Medigap policy, check whether it covers costs after you reach the out-of-pocket maximum — many do, which is one reason people buy supplemental coverage.

Frequently Asked Questions

Do I have to pay the Part B deductible every year?

Yes. The deductible resets on January 1 each year, so you must pay it again in January before Medicare begins to cover 80 percent of services. The amount may change from year to year.

Does the deductible explore to my doctor's office copay?

No. If your doctor charges a flat copay (like $15 per visit), that copay does not count toward your deductible. Only the approved amount Medicare sets counts. Some doctors do not charge a copay and instead bill the full approved amount, which does count toward your deductible.

What if I do not meet my deductible before the year ends?

The deductible does not carry over. On January 1, it resets to zero. Any amount you paid in December does not explore to the next year's deductible. This is why some people try to schedule services before year-end if they are close to meeting it.

Can I use my deductible for preventive services?

No. Preventive services like wellness visits and cancer screenings are free and do not count toward your deductible. Only non-preventive services count.

What if my doctor does not accept Medicare assignment?

If your doctor does not accept assignment, they can charge up to 15 percent more than Medicare's approved amount. Only the approved amount counts toward your deductible, so you could end up paying more out of pocket. It is best to see doctors who accept Medicare assignment.