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What Is the 2018 Medicare Part B Deductible? 

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.

In 2019, the Medicare Part B deductible is $185 per year.

Man sitting at a table reviewing documents

Most deductibles reset every year, as is the case with the Medicare Part B deductible. Each year that you are enrolled in Part B, you must first reach the deductible amount in your own health care spending before Medicare will begin to provide additional cost coverage.

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 .

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 $185 in covered spending for the year in 2019).

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.

How much is the Medicare Part B deductible?

As mentioned above, the 2019 Medicare Part B deductible is $185 per year. Below is a look at how the Part B deductible has increased (and in one case, decreased) since 2008.1

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

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 that cover 100% 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.
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  • Medicare Advantage
    Enrolling in a Medicare Part C plan (also called a Medicare Advantage plan) is another way of avoiding the Part B deductible. 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.2

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.

Speak with a licensed insurance agent to find the right plan for your by calling TTY Users: 711 24 hours a day, 7 days a week.

 

1 Norris, Louise. (March 12, 2018). Did the Medicare Part B deductible increase again for 2018? MedicareResources.org. Retrieved from https://www.medicareresources.org/faqs/if-medicare-part-b-deductibles-increase-in-2016-will-all-medicare-enrollees-be-affected.

2 You must continue to pay your Medicare Part B premium. $0 premium plans are not available in all areas.

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*$0 premium plans may not be available in all areas.

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