What Are the 2020 Medicare Deductibles?

What is the Medicare Part B deductible for 2020?

In 2020, the Medicare Part B deductible is $198 per year.

What is the Medicare Part A deductible for 2020?

The Medicare Part A deductible for 2020 is $1,408 per benefit period

Unlike the deductible for Part B that operates on an annual basis, the Part A deductible starts and stops with each benefit period.

A benefit period begins the day you are admitted for inpatient care at a hospital or skilled nursing facility, and it ends when you have gone 60 consecutive days without inpatient treatment.

For example, if you are admitted for inpatient hospital care on June 1 and are discharged on June 10, you would still be in the same benefit period if you were admitted again for inpatient care on June 30. You wouldn't have to meet your Part A deductible again if you already met that deductible during your first hospital stay.

If, however, you were discharged on June 10 and were readmitted to the hospital in October of the same year, you would be in a new benefit period. You would need to meet the Part A deductible again before your Medicare Part A coverage would kick in again.

Man sitting at table reviewing documents

Is there a deductible with Medicare?

Yes, both Medicare Part A and Medicare Part B each come with a deductible. 

Medicare Advantage (Part C) and Medicare Prescription Drug Plans (Part D) may also include deductibles as well, although the costs associated with these plans are not standardized like they are in Original Medicare (Part A and Part B). Some Part D plans include $0 deductibles before the plan's drug coverage kicks in.

Medicare defines a deductible as:

“The amount you must pay for health care or prescriptions before Original Medicare, your prescription drug plan, or your other insurance begins to pay.”

In other words, a deductible is the amount that you must first pay out of your own pocket for health care before your Medicare insurance coverage kicks in.

What counts toward the Medicare Part B deductible?

Basically, any service or item that is covered by Part B counts toward your Part B deductible.

For example, imagine you fall and break your leg. You are taken to a hospital, treated, and released with a pair of crutches.

The care you receive as a hospital inpatient is covered under Medicare Part A (hospital insurance). But the crutches are covered under Medicare Part B (medical insurance).

The amount that you are charged for the doctor, treatment, and the crutches will count toward your Part B deductible, while the bill for your hospital stay will count toward your Part A deductible.

Each part of Medicare carries its own deductible. The Part A and Part B deductibles are standard for each beneficiary of Original Medicare.

The Part C (Medicare Advantage) and Part D (prescription drug plan) deductibles will vary from plan to plan. Some Part C and Part D plans may have a $0 deductible.

What happens once you reach the deductible?

Once you meet the required Medicare Part B deductible, you will typically be charged a 20 percent coinsurance for all Part B-covered services and items for the remainder of the year.

Coinsurance is the amount of the total bill that you must pay. A 20 percent coinsurance means you (the beneficiary) would be responsible for 20 percent of a medical bill, while Medicare would pay the remaining 80 percent.

It’s worth noting that the 20 percent you will pay as coinsurance is 20 percent of the Medicare-approved amount.

The Medicare-approved amount is the maximum amount that a health care provider is allowed to charge for a service or item as determined by Medicare.

Let’s use the broken leg scenario from above and say that the cost of the pair of crutches was $80.

  • If the injury happened before reaching your Medicare Part B deductible, you would be responsible for the full $80 (or the amount it would require you to reach $198 in covered spending for the year in 2020).

  • If you had already met the Part B deductible prior to the injury happening in this hypothetical situation, you would only be responsible for $16 (20 percent of $80). Medicare would then pay the remaining $64.

What was the Medicare Part B deductible for 2019?

In 2019, the Medicare Part B Deductible was $185 per year.

As mentioned above, the 2020 Medicare Part B deductible is $198 per year.

Below is a look at how the Part B deductible has increased (and in one case, decreased) since 2008.

Medicare Part B Deductible By Year
2008 $135
2009 $135
2010 $155
2011 $162
2012 $140
2013 $147
2014 $147
2015 $147
2016 $166
2017 $183
2018 $183
2019 $185
2020 $198

Is there a way to avoid paying the Medicare Part B deductible?

There are two ways you may be able to avoid having to pay the Medicare Part B deductible:

  • Medicare Supplement Insurance
    Medicare Supplement Insurance (also called Medigap) is a type of privately-sold insurance plan that is used in conjunction with Medicare Part A and Part B.

    Medigap plans help provide coverage for some of the out-of-pocket expenses that Medicare beneficiaries are responsible for paying, such as Medicare coinsurance and deductibles.

    There are two Medicare Supplement Insurance plans (Plan F and Plan C) that cover 100 percent of the Medicare Part B deductible. If you enroll in one of these types of plans and pay a monthly premium to belong to the plan, you will not have to pay out of your own pocket for the Medicare Part B deductible.

    It's important to note that Plan F and Plan C are no longer available for new Medicare beneficiaries who became eligible for Medicare after January 1, 2020.

    If you became eligible for Medicare before that date, you may still be able to enroll in either plan if they are available where you live. If you already had Plan C or Plan F before January 1, 2020, you can keep your plan.

    Most of the 10 standardized types of Medigap plans available in most states provide partial or full coverage of the Part A deductible.
  •  
  • Medicare Advantage
    Enrolling in a Medicare Part C plan (also called a Medicare Advantage plan) is another way of avoiding the Part B deductible.

    It's important to note that Medicare Part C is a term only used for Medicare Advantage plans, and it's not the same as Medigap Plan C.

    Medicare Advantage plans provide the same benefits as Medicare Part A and Part B in one plan and serve as an alternative way to get Original Medicare coverage.

    Many Medicare Advantage plans may also offer some additional benefits not covered by Medicare Part A and Part B.

    Medicare Advantage plans may have their own deductible, but you will not be responsible for the Medicare Part B deductible if you are enrolled in a Medicare Advantage plan. You will only be responsible for paying your Medicare Advantage plan deductible.

    As mentioned above, some Medicare Advantage plans have no deductible, and some plans even offer $0 monthly premiums.

Explore your Medicare enrollment options

If you have further questions about the Medicare Part B deductible or any other costs associated with Medicare, explore our guide to Medicare costs.

Learn more about your Medicare enrollment options. If you want to have Medicare health coverage without having to pay the Medicare Part B deductible, you may want to consider enrolling in a Medicare Advantage plan.

Call today to speak with a licensed insurance agent to find the right plan for your needs.

 

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