How Much Are My Medicare Deductibles?

Medicare is a federal health insurance program for individuals aged 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease. A deductible represents the amount you must pay out-of-pocket for covered services before your insurance begins to contribute. Medicare is structured into different parts, each with its own deductible framework. This article details the specific deductible amounts for Medicare Parts A, B, and D for 2024.

Medicare Part A Deductible

Medicare Part A, which covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services, has a deductible that applies per benefit period. For 2024, the inpatient hospital deductible for Medicare Part A is $1,632. This amount covers a beneficiary’s share of costs for the first 60 days of Medicare-covered inpatient hospital care within a single benefit period.

A benefit period begins the day you are admitted as an inpatient to a hospital or skilled nursing facility. It concludes when you have been out of a hospital or skilled nursing facility for 60 consecutive days. You may incur multiple benefit periods within a single year, and a new Part A deductible may apply for each new benefit period if the 60-day break in care is met.

Beyond the initial deductible, coinsurance amounts apply for longer inpatient stays. For hospital stays extending from day 61 through day 90 in a benefit period, the daily coinsurance amount is $408 in 2024. If a hospital stay exceeds 90 days, beneficiaries can utilize up to 60 lifetime reserve days, for which the daily coinsurance is $816 per day. Once these lifetime reserve days are exhausted, beneficiaries are responsible for all costs. For skilled nursing facility care, there is no coinsurance for the first 20 days within a benefit period, but from day 21 through day 100, the daily coinsurance amount is $204.00.

Medicare Part B Deductible

Medicare Part B covers medical services and supplies that are medically necessary, including doctor visits, outpatient care, durable medical equipment, and some preventive services. Unlike Part A, Part B has an annual deductible that applies once per calendar year. For 2024, the annual deductible for all Medicare Part B beneficiaries is $240.

After this annual deductible is met, Medicare typically pays 80% of the Medicare-approved amount for most covered services. The beneficiary is then responsible for the remaining 20% coinsurance. This structure applies to a wide range of services, such as physician visits, outpatient therapy, and many diagnostic tests.

Medicare Part D Deductibles and Cost-Sharing

Medicare Part D provides prescription drug coverage, which is offered through private insurance companies approved by Medicare. The deductible for Medicare Part D plans can vary considerably among different plans. For 2024, Medicare sets a maximum allowable deductible for Part D plans at $545.

Once the plan’s deductible is satisfied, beneficiaries typically pay a copayment or coinsurance for their prescriptions. The specific amounts for these cost-sharing payments depend on the individual plan and the tier of the prescribed drug. Part D coverage also involves different phases, including the initial coverage phase, the coverage gap (sometimes referred to as the “donut hole”), and catastrophic coverage.

Medicare Supplement Plans and Deductibles

Medicare Supplement Insurance plans, also known as Medigap, are designed to help cover some of the out-of-pocket costs that Original Medicare (Parts A and B) does not cover. These plans are sold by private companies and can help pay for deductibles, copayments, and coinsurance. Medigap plans work by paying expenses after Original Medicare has paid its share.

Many Medigap plans can cover the Part A inpatient hospital deductible. Certain plans may also cover the annual Part B deductible.

Depending on the specific Medigap plan selected, it can also cover the 20% Part B coinsurance that beneficiaries typically pay after meeting their deductible. These plans help reduce unpredictable out-of-pocket costs by providing additional coverage for services covered by Original Medicare.