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Each of the four parts of Medicare carries its own deductibles, a predetermined amount of money that you must pay for health care before coverage actually kicks in.
The current Medicare deductible is $233 per year for Medicare Part B and $1,556 per benefit period for Medicare Part A.
The deductibles for Medicare Parts C, D and Medigap vary depending on the plan.
Medicare Deductibles in 2022
Medicare deductibles are set annually by the plan’s administrator, which could be either the government agency or a private insurance company. Deductibles can range from $0 to several thousand dollars.
|Part A (inpatient care)||$1,556 for each hospital benefit period|
|Part B (outpatient care)||$233 per year|
|Part C (Medicare Advantage bundle)||Varies by plan, ranging from $0 to more than $1,000|
|Part D (prescriptions)||Varies by plan, and can't be higher than $480|
|Medigap (Medicare supplement)||Plans usually have no deductible and can reduce the Part A and B deductibles|
What is a deductible?
A deductible is the amount you are required to pay for health care or prescription drugs before your Medicare plan begins to pay its share.
Let's take Medicare Part A as an example. If you spend three days in the hospital, you pay the first $1,556 in expenses, the amount of your deductible. After this, Medicare will then pick up the rest of your covered Part A expenses for your three-day hospital stay because you have a $0 copay, which is the cost-sharing amount you pay after having met your deductible.
Medicare Part A deductible in 2022
Medicare Part A, which covers hospitalizations and skilled nursing facilities, carries a deductible of $1,556 in 2022, applied to each hospital benefit period.
That means that for each benefit period, you must pay the $1,556 deductible before Medicare coverage kicks in and starts to pay for your inpatient care. After meeting the Part A deductible, you don’t pay anything in Medicare Part A costs until day 61 of your hospitalization.
A hospital benefit period begins as soon as you are admitted to the hospital or skilled nursing facility and ends only after you’ve been out of the hospital or skilled nursing facility for 60 consecutive days. After this, a new benefit period begins, requiring you to meet the Part A deductible if you are hospitalized again.
Why the hospital benefit period matters for your Part A deductible
With Medicare Part A, you could end up paying the deductible more than once a year if you have multiple hospitalizations that fall in different hospital benefit periods.
For example, if you complete your three-day hospitalization on June 3 but are readmitted to the hospital on Aug. 10, more than 60 days after you were discharged on June 3, you will have to pay the Part A deductible again because you are in a new hospital benefit period.
By the same token, if you are readmitted to the hospital within 60 days of being discharged, you would not pay the Part A deductible again because you have already paid it for that hospital benefit period.
How much do you pay after meeting your Part A deductible?
After paying the initial $1,556 in costs for the deductible, you'll have no costs for the first 60 days of inpatient care. However, prolonged stays in a hospital or skilled nursing facility can cost several hundred dollars a day.
Medicare Part A hospitalization coinsurance:
- Days 1-60: $0 after first paying the deductible of $1,556
- Days 61-90: $389 per day
- Days 91-150: $778 per day with hospital reserve days
- All costs after day 150
If you are still in the hospital after 60 days, Medicare will charge a coinsurance rate of $389 per day from days 61 through 90. If you are still in the hospital or inpatient facility after 90 days, Medicare will begin drawing from your lifetime reserve days, a bank of 60 days that you can use only once during your lifetime to mitigate costs for hospital days 91 through 150.
Even when using your lifetime reserve days, you still have to pay a hefty coinsurance of $778 per day in 2022 for hospital days 91 through 150. You can elect to defer or bank some of your reserve days for a future hospitalization. But if you do not use your hospital reserve days for hospital days 91 through 150, you will have to pay the full cost of your hospitalization, which can easily result in thousands and thousands of dollars.
During a prolonged hospital stay, you may end up using 30 of your 60 lifetime reserve days, meaning you have 30 lifetime reserve days to use at a later date. But once you use your reserve days, they are gone.
The Medicare Part A deductible of $1,556 applies to both hospital and skilled nursing facility stays, meaning you only have to meet the deductible once for each hospital benefit period, regardless of the type of facility.
For example, if you spend three days in the hospital and are then sent to a skilled nursing facility for another week of rehabilitation, you will only have to meet the deductible once when you are first admitted to the hospital. You are not required to meet the deductible again for the skilled nursing facility stay because you are still within the same hospital benefit period.
Medicare Part A skilled nursing facility coinsurance:
- First 20 days: $0 costs if the Part A deductible has been met
- Days 21-100: $194.50 per day
- After day 100, you pay all costs
After meeting your deductible, Medicare Part A pays most, but not all, of your hospitalization costs. For instance, you are still responsible for paying Part B copays for physician services provided during your hospital stay.
Medicare Part A also does not cover a private room in a hospital or a skilled nursing facility unless it is deemed medically necessary. And it will not pay for custodial services — help with activities such as dressing, feeding, bathing or going to the bathroom.
Medicare Part B deductible in 2022
In 2022, the Medicare Part B deductible is $233.
So you'll pay in full for the first $233 of your outpatient care before the cost-sharing begins. After you meet the deductible, you'll typically pay 20% of the cost for doctor appointments, diagnostics and other outpatient care.
Like the Medicare Part A deductible, the Medicare Part B deductible increases slightly every year.
But unlike the Part A deductible, the Part B deductible is an annual deductible based on the calendar year. You only have to meet the Part B deductible once a year, and a new deductible takes effect on Jan. 1.
How the annual deductible could impact new enrollees
If you qualify for Medicare late in the calendar year — say, in November or December — you could end up paying the Medicare Part B deductible more than once within a few months or even a few weeks.
For example, if you enroll in Medicare in December 2022, when you get medical care that month, you will have to meet the Part B deductible of $233 for 2022, and then in January, you will have another deductible for 2023, effectively paying the Part B deductible twice within a few weeks.
In other words, if your Medicare coverage begins late in the calendar year, you may want to postpone non-urgent medical procedures until the new year to avoid paying the Medicare part B deductible twice within a few week span.
What's not included in the Medicare Part B deductible?
Medicare Part B pays the full cost of some preventive and wellness care, whether or not you've met the plan's deductible.
Medicare provides a free "Welcome to Medicare" visit during your first 12 months of enrollment in Medicare Part B. This free visit, which is not subject to deductibles or copays, includes a review of your medical and social history as well as education and counseling about preventive services.
In addition, Medicare provides a yearly wellness visit at no cost if you have been enrolled in Medicare Part B for more than 12 months.
Like the Affordable Care Act, Medicare Part B also covers recommended preventive services at no cost. This includes screenings and vaccinations recommended by the U.S. Preventive Services Task Force. In order to qualify for free preventative services, beneficiaries have to see a provider that accepts Medicare.
Medicare Advantage deductible in 2022
The deductible of a Medicare Advantage plan can range from $0 to more than $1,000 dollars.
Medicare Advantage, also called Medicare Part C, is sold by private insurance companies so the annual deductible varies by insurer and plan.
However, many Medicare Advantage plans charge separate deductibles for medical and prescription drug coverage, requiring beneficiaries to meet two separate deductibles that can each average more than $300.
Enrollees in a Medicare Advantage plan do not also have to pay the deductible for Part A or a Part B.
For example, if you were admitted to the hospital with a Medicare Advantage plan, you wouldn't pay the Part A deductible or copays. Instead, you'd pay the Medicare Advantage plan's deductible (if you haven't met it already) and the plan's daily copays for hospital care. This can average $100 to $500 per day, depending on the plan. After the first several days of hospitalizations, many Advantage plans charge nothing.
Other costs with a Medicare Advantage plan
Medicare Advantage plans charge their own monthly premiums and copays for medical care.
In addition to any monthly cost for the Medicare Advantage plan, beneficiaries enrolled in Medicare Advantage plans are also required to pay the Medicare Part B monthly premium, which is $170.10 in 2022.
Medicare Part D deductible in 2022
Most Medicare Part D plans charge deductibles, which average $368 a year per plan.
By law, Medicare Part D cannot charge more than $480 in deductibles in 2022, and many of the Medicare Part D plans charge this maximum amount. A small percentage of the Medicare Part D plans, 18%, do not impose deductibles.
Like Medicare Part C, Medicare Part D is privatized, meaning private insurance companies contract with Medicare to sell and administer the plans. And like other insurance plans, Medicare Part D plans also charge their own premiums and copays.
Medicare Parts A and B do not offer a prescription drug benefit, prompting most Medicare beneficiaries enrolled in original Medicare to buy a policy under Medicare Part D. In 2022, approximately 48.7 million Medicare enrollees out of 62.2 million are enrolled in Medicare Part D.
Medigap deductible in 2022
Most Medigap policies do not have their own deductibles, but these supplemental plans can help pay for the Part A and B deductibles.
Medigap plans, which are sold by private insurance companies, are labeled A through N, the letters denoting the extent of coverage and if it covers other deductibles.
Nearly all Medigap plans cover at least some of the Medicare Part A deductible, but only Medigap plans B, C, D, F, G and N cover 100% of the Part A deductible. All of the plans cover Medicare Part A coinsurance costs while providing you with 365 additional days of hospital coverage beyond your lifetime reserve days.
Only two Medigap policies, Plans C and F, cover the Medicare Part B deductible, but these plans are not available to Medicare beneficiaries who became eligible for Medicare on or after Jan. 1, 2020. Medigap policies are no longer allowed to offer coverage for the Medicare Part B deductible as a result of legislation that took effect in 2020.
When do Medigap plans have their own deductibles?
In some states, there are high-deductible versions of Medigap Plans G and F, in addition to the standard plans. This requires beneficiaries to meet a deductible of $2,490 before the Medigap coverage kicks in.
Before your medical spending reaches the Medigap deductible, you would still have coverage through Medicare Parts A and B and would follow those plan's rules about the deductibles and copayments you must pay when getting medical care. But after your spending reaches the Medigap deductible, your Plan F or G benefits would cover most of your medical costs.
A high-deductible Medigap plan has much lower premiums, perhaps $40 a month compared to $120 a month in premiums.
Frequently asked questions
Does Medicare have a deductible?
Original Medicare has a deductible of $1,556 for each hospital benefit period under Part A. Medicare Part B, which covers outpatient care and services, carries an annual deductible of $233 in 2022. The deductibles for Medicare Advantage, Medicare Part D and Medigap plans vary depending on the plans.
How do you check if you’ve met your Medicare deductible?
If you are enrolled in Original Medicare, Medicare will send you a Medicare Summary Notice (MSN) listing all of the services billed to Medicare, the portion Medicare paid and whether you have met your deductibles. If you are enrolled in a Medicare Advantage plan, your insurance company can tell you what has been paid and if you met your deductible.
How much is the deductible for Medigap Plan G?
Medigap Plan G usually does not have its own deductible. But with a standard Medigap Plan G, you are required to pay the Medicare Part B deductible of $233 before it picks up coverage. In some states, a cheaper high-deductible Plan G is available, requiring beneficiaries to meet a deductible of $2,490 before coverage kicks in.
Do Medicare Advantage plans have deductibles?
Some Medicare Advantage plans do not have deductibles, while others charge a few hundred dollars to a few thousand dollars in deductibles. It all depends on the plan.