Your Medicare deductible is the amount of money you have to pay for health care or prescriptions before Original Medicare or other insurance begins to pay. In 2021, the deductible is $1,484 for Medicare Part A and $203 for Part B. Medicare Advantage and Part D deductibles vary based on your plan.
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.
Medicare Part A 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.
For 2021, the Medicare Part A deductible is $1,484 for each benefit period. If you re-enter the hospital or skilled nursing facility any time after your benefit period ends, you will have to pay the first $1,484 again as a new deductible.
Medicare Part B Deductible
For 2021, your Medicare Part B deductible is $203. That’s up from $198 in 2020.
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 percent of the Medicare-approved costs for most doctor services, outpatient care and durable medical equipment — things such as wheelchairs or walkers your doctor may order for you.
Deductibles for Drug Coverage and Medicare Advantage
Deductibles for Medicare Part C, also known as Medicare Advantage plans, and Medicare Part D prescription drug coverage varies based on the plan you purchase. Both Medicare Advantage and Part D 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 2021, the MOOP for Medicare Advantage plans is $7,550 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 has to cover 100 percent of all further costs.
Some Medicare Part D prescription drug plans don’t have a deductible. Those that do may not have a deductible of more than $445 in 2021.
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 10 standardized plans across 47 states and the District of Columbia. There are different standardized plans for Minnesota, Massachusetts and Wisconsin.
Each plan has a letter for a name. Some of these plans may cover all or a portion of your Part A deductible.
Medigap Plans C and F were the only two to cover the deductible for Medicare Part B. However, Plans C and F are available only to people who became eligible for Medicare before Jan. 1, 2020.
7 Cited Research Articles
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- U.S. Centers for Medicare & Medicaid Services. (2019, November 22). Chapter 3 - Deductibles, Coinsurance Amounts, and Payment Limitations. Retrieved from https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/ge101c03.pdf
- U.S. Centers for Medicare & Medicaid Services. (2019, November 8). 2020 Medicare Parts A & B Premiums and Deductibles. Retrieved from https://www.cms.gov/newsroom/fact-sheets/2020-medicare-parts-b-premiums-and-deductibles
- Livingston, S. (2019, November 8). Drug Spending Drives Higher 2020 Medicare Part B Premiums, Deductibles. Retrieved from https://www.modernhealthcare.com/medicare/drug-spending-drives-higher-2020-medicare-part-b-premiums-deductibles
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Medicare Costs at a Glance. Retrieved from https://www.medicare.gov/your-medicare-costs/medicare-costs-at-a-glance
- 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
- Humana. (n.d.). Deductibles for Medicare Part A and Part B. Retrieved from https://www.humana.com/medicare/medicare-information/medicare-coverage-and-benefits/part-a-b-deductibles-review?kc=0300021477