Medicare Parts A and B have deductibles that must be met before Medicare starts paying. Medicare deductibles are reset each year — for 2023, the Part B deductible lowered and the Part A deductible raised. Medicare Advantage, Medigap and Part D plans are all sold by private insurance companies that set their own deductibles. Learn about each part of Medicare’s deductibles for 2023 and how Medigap can help cover deductible costs.
- Written by Terry Turner
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Terry Turner has more than 35 years of journalism experience, including covering benefits, spending and congressional action on federal programs such as Social Security and Medicare. He is a Certified Financial Wellness Facilitator through the National Wellness Institute and the Foundation for Financial Wellness and a member of the Association for Financial Counseling & Planning Education (AFCPE®).Read More
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- Published: May 11, 2020
- Updated: May 24, 2023
- 7 min read time
- This page features 12 Cited Research ArticlesKey Takeaways
- The 2023 Medicare deductible for Part A is $1,600 for each benefit period: $0 for days 1-60, $400 coinsurance per day for days 61-90 and $800 per each "lifetime reserve day" after 91 days.
- The Medicare Part B deductible is $226. Once met, you pay 20% of the Medicare-approved amount for most doctor services, outpatient therapy and durable medical equipment.
- Part C and Part D deductibles are set by private insurers.
Deductibles for Original Medicare
Medicare premiums, deductibles and coinsurance rates for Original Medicare are adjusted each year. Original Medicare includes Medicare Part A hospital insurance and Part B medical insurance. Each has different deductibles.
Once your deductible is paid off, Medicare pays the rest. Know that some copays and coinsurance costs may apply due to other factors, like the duration of your hospital stay.Did You Know?With Medicare Part A, there are no deductibles or copayments for hospice care and home health care — as long as you meet eligibility requirements.Source: National Council on Aging
You can find out if you’ve met your Medicare Part A or Part B deductible for the year at MyMedicare.gov.
Medicare Part A Deductible in 2023
For 2023, the Medicare Part A deductible is $1,600 for each benefit period. If you re-enter the hospital or skilled nursing facility at any time after your benefit period ends, you will have to pay the first $1,600 again as a new deductible.
Medicare Part A covers certain hospitalization costs, including inpatient care in a hospital, skilled nursing facility care, hospice and home health care. It does not cover long-term custodial care.
Your 2023 Part A deductible will share costs for the first 60 days you stay in a hospital in one benefit period. You will be responsible for paying coinsurance after 60 days pass.Hospital Stay Costs with Part A in 2023
Length of Stay You Pay: 1–60 Days $0 6–90 Days $400 91+ Days* $800
For example, let’s say you need hospital treatment for a hip fracture. Your hip fracture treatment will likely cost between $13,000 and $40,000 depending on the severity of your injury and your location. We’ll price the treatment for your fracture at $20,000.
With Part A, your deductible will be met at $1,600, then Medicare will cover the remaining $18,400. According to the Icahn School of Medicine, you’ll likely only stay in the hospital for three to five days, meaning you won’t need to pay any coinsurance.What Is a Benefit Period?This is how Medicare measures your use of inpatient hospital care or services in a skilled nursing facility. The benefit period begins the day you enter the hospital or facility and ends after you have not needed inpatient care for 60 days in a row.Don't Leave Your Health to ChanceFind a local Medicare plan that fits your needs by connecting with a licensed GoHealth insurance agent.
Medicare Part B Deductible in 2023
Your Medicare Part B deductible is $226 in 2023. That’s a $7 decrease from 2022.
Unlike Medicare Part A, there is no benefit period tied to Medicare Part B.
After meeting the deductible, you’ll usually have to pay 20% of the Medicare-approved costs for most doctor services, outpatient care and durable medical equipment like wheelchairs or walkers your doctor may order for you.
For example, let’s say you require an electric wheelchair that costs $2,000. If you’ve met your $226 deductible, the electric wheelchair will only cost you around $400, which is 20% of the original cost.
Deductibles for Drug Coverage and Medicare Advantage in 2023
Your deductible for Part D coverage can’t exceed $505 in 2023. Your deductible will vary by plan; some Medicare Part D prescription drug plans don’t have a deductible at all.
According to the Kaiser Family Foundation, 191 Part D stand-alone drug plans won’t charge a premium at all for enrollees receiving the low-income subsidy plans in 2023.
There are four coverage periods for Part D, which influence your overall costs.
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- Deductible Period
- If your Part D plan covers a medication, you’ll pay the full price until your deductible is met. Once your deductible is met, Part D will begin to provide coverage.
- Initial Coverage Period
- During this phase, you could potentially pay copayments or coinsurances for your medication. The initial coverage period stops once you’ve accumulated $4,660 in 2023. This includes what you and your plan have paid for covered medications.
- Coverage Gap
- Once you surpass $4,430 in medication costs, you enter the Part D coverage gap, also known as the “donut hole.” You are responsible for paying 25% of the costs of your plan’s covered brand-name drugs during this period. Note that if you’re in the Extra Help program, you won’t enter the coverage gap.
- Catastrophic Coverage
- Once you reach $7,400 in out-of-pocket costs for 2023, including your deductible, you’ll pay significantly lower copays and coinsurance for the rest of the year.
Deductibles for Medicare Advantage in 2023
Deductibles for Medicare Part C, also known as Medicare Advantage plans, vary based on the plan you purchase. Medicare Advantage plans are sold by private insurers that have contracts with the Medicare program.
Medicare Advantage plans may offer coverage that absorb some of your out-of-pocket costs. Though Medicare Advantage deductibles may vary, all plans must set a limit on your maximum out-of-pocket (MOOP) expenses. This is a total spread across your deductibles, coinsurance and copayments.
For 2023, the MOOP for Medicare Advantage plans is $8,300 for in-network care. It can be higher for out-of-network care or services. But once you hit your MOOP for the year, the plan must cover 100% of all further costs.
Make sure to explore Medicare Advantage plans in your area and compare deductible costs before making a purchase. Note that some plans have separate deductibles for drug and health coverage. For example, one Humana Medicare Advantage Plan in Florida has a $0 health deductible and a $150 drug deductible.
Using Medigap to Pay Medicare Deductibles
Medigap, also known as Medicare Supplement plans, can help pay some of your out-of-pocket costs, including your Medicare Part A deductibles.
These plans are sold through private insurers. There are eight standardized plans across 47 states and the District of Columbia. There are different standardized plans for Minnesota, Massachusetts and Wisconsin.Did you know?Plans C and F, the only plans that cover the Part B deductible, are no longer available to new Medicare applicants as of January 1, 2020. You can keep your coverage if you had a plan before the cut-off date. If you were eligible for Medicare before January 1, 2020, but not yet enrolled, you may be able to buy a Plan C or F plan.
Each Medigap plan has a letter for a name. Some of these plans may cover all or a portion of your Part A or B deductible.Medigap Plan Coverage of Part A Deductibles
Deductible Type A B C D F* G* K** L** M N Part A 50% 75% 50% Part B
*Plans F and G offer a high-deductible plan in some states. You must pay Medicare covered costs up to the 2023 deductible of $2,700 before your policy provides coverage.
**With Plans K and L, after you meet your 2023 yearly out-of-pocket limit ($6,620 and $3,310, respectively) and Part B deductible, both plans cover 100% of covered services for the rest of the year.Never Miss Important News or Updates with Our Weekly NewsletterGet money-saving tips, hard-to-find info and tactics for a successful retirement in our free weekly newsletter.
Frequently Asked Questions About Medicare DeductiblesDoes Medicare have a deductible?Yes, you have to pay a deductible if you have Medicare. You will have separate deductibles to meet for Part A, which covers hospital stays, and Part B, which covers outpatient care and treatments.What is the Medicare deductible for 2023?How do Medicare deductibles work?A deductible is the amount of money that you have to pay out-of-pocket before Medicare begins paying for your health costs. For example, if you received outpatient care or services covered by Part B, you would then pay the first $226 to meet your deductible before Medicare would begin covering the remaining cost.Last Modified: May 24, 2023Share This Page
12 Cited Research Articles
- Kaiser Family Foundation. (2022, October 19). An Overview of the Medicare Part D Prescription Drug Benefit. Retrieved from https://www.kff.org/medicare/fact-sheet/an-overview-of-the-medicare-part-d-prescription-drug-benefit/
- U.S. Centers for Medicare & Medicaid Services. (2022, September 30). F, G & J Deductible Announcements. Retrieved from https://www.cms.gov/medicare/health-plans/medigap/fandj
- U.S. Centers for Medicare & Medicaid Services. (2022, September 30). K & L Out-of-Pocket Limits Announcements. Retrieved from https://www.cms.gov/medicare/health-plans/medigap/kandl
- U.S. Centers for Medicare & Medicaid Services. (2022, September 27). 2023 Medicare Parts A & B Premiums and Deductibles 2023 Medicare Part D Income-Related Monthly Adjustment Amounts. Retrieved from https://www.cms.gov/newsroom/fact-sheets/2023-medicare-parts-b-premiums-and-deductibles-2023-medicare-part-d-income-related-monthly
- Federal Register. (2022, April 14). Medicare Program; Maximum Out-of-Pocket (MOOP) Limits and Service Category Cost Sharing Standards. Retrieved from https://www.federalregister.gov/documents/2022/04/14/2022-07642/medicare-program-maximum-out-of-pocket-moop-limits-and-service-category-cost-sharing-standards
- National Council on Aging. (2022, March 2). What Is the Medicare Deductible? Retrieved from https://www.ncoa.org/article/what-is-the-medicare-deductible
- U.S. Centers for Medicare & Medicaid Services. (2022). Catastrophe Coverage. Retrieved from https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/catastrophic-coverage
- U.S. Centers for Medicare & Medicaid Services. (2022). Costs in the Coverage Gap. Retrieved from https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/costs-in-the-coverage-gap
- U.S. Centers for Medicare & Medicaid Services. (2022). Find a Medicare Plan. Retrieved from https://www.medicare.gov/plan-compare/#/search-results?plan_type=PLAN_TYPE_MAPD&fips=12117&zip=32765&year=2023&lang=en&page=2
- Icahn School of Medicine at Mount Sinai. (n.d.). Hip Fracture Surgery. Retrieved from https://www.mountsinai.org/health-library/surgery/hip-fracture-surgery
- Morgan & Morgan. (n.d.). What Are the Costs and Recovery Time for a Broken Pelvis? Retrieved from https://www.forthepeople.com/personal-injury-lawsuits/what-are-the-costs-and-recovery-time-for-a-broken-pelvis/
- U.S. Centers for Medicare & Medicaid Services. (n.d.). How To Compare Medigap Policies. Retrieved from https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies
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