Written by Jordan McElwain — Updated: Friday, March 17, 2023
When considering the cost of Medicare, most people think about the Medicare premiums that they pay every month. But your premiums aren’t the only healthcare costs you’ll incur if you need medical services. You also need to consider your out-of-pocket costs, including deductibles and coinsurance. In this article, we’ll explore the details of Medicare deductibles—how they work and what they typically cost.
Medicare deductibles work similarly to home and auto insurance deductibles. Your Medicare deductibles are the amounts you’ll pay out of your own pocket (or bank account) for healthcare services before Medicare starts paying. Each part of Medicare has its own deductible, so it’s important to not only be aware of what your deductibles are but also what you’ve paid toward each deductible.
For a general example of how deductibles work, let’s say you have a deductible of $1,000 and need a service that’s covered by your insurance and costs $2,000. Assuming you haven’t yet paid any healthcare costs, you’ll pay the first $1,000, then your insurance will kick in and start paying for its share of the remaining $1,000—how much depends on your coinsurance.
While many Medicare-covered services require paying toward your deductible, there are some services that do not, including preventive services like flu shots and annual wellness visits.
2023 Part A Deductible: $1,600
Medicare Part A is your hospital insurance. Its deductible covers your share of costs for the first 60 days of each inpatient hospital benefit period. Benefit periods start the day you’re admitted as an inpatient and end when you haven’t received inpatient care for 60 days in a row. This means that the Part A deductible is not an annual amount, and you may pay the deductible multiple times in a year for different hospital stays.
2023 Part B Annual Deductible: $226
Medicare Part B is your non-hospital, medical insurance and its annual deductible will be met once you pay $226 for supplies or services covered by Part B.
Medigap plans are a type of supplemental Medicare insurance that help cover the costs that Original Medicare (Part A & B) doesn’t pay for. All Medigap plans pay for some (if not all) of your Medicare Part A deductible, which could save you $1,600 or more on deductibles alone.
Plans C and F are the only Medigap plans that cover the Part B deductible, but they are not available for those who are newly eligible for Medicare.
Medicare Advantage deductibles vary, and it’s important to be aware of and compare plan deductibles before you enroll. Because Medicare Advantage plans bundle Medicare Part A and Part B, the deductibles are combined into one.
Coverage of inpatient care is also handled differently. Medicare Advantage plans generally opt to charge a daily copayment starting on day one of a hospital stay rather than imposing the Part A benefit period deductible.
2023 Maximum Part D Deductible: $505
There are two ways to get prescription drug coverage—via a stand alone prescription drug plan (PDP) or a Medicare Advantage plan with prescription drug coverage (MAPD).
For MAPD plans, there are often two deductibles—one for general healthcare costs and one for prescription drug coverage. Deductibles will vary from one Medicare Advantage plan to the next, but in some cases, MAPD plans may have a $0 deductible for either general healthcare costs or prescription drug coverage.
For PDP plans, deductibles can vary, but the average deductible in 2023 is $408. Some PDPs will have a $0 deductible, but these plans tend to have higher premiums. When looking at plan costs, be sure to look at all of your potential expenses, including deductibles, premiums, copayments, and coinsurance to fully understand and compare plan values.
If you have questions about how deductibles work or want help finding a plan that will minimize your costs, pick a time to talk to one of our licensed Advisors.