What is a Medicare Deductible?

The word deductible gets thrown around a lot in the world of insurance, and I run across people all the time that still aren’t sure what it means.

Don’t feel intimidated if you don’t know, because you are not alone!

A deductible is simply a set dollar figure you must pay toward medical expenses before the benefits of your policy kick in.

This is very common in auto insurance. If you get in a wreck, you may have to pay $500, or $1,000 out of pocket first, before the insurance company pays their share of the damage. Generally the higher the deductible, the lower the policy premium.

The same holds true for health insurance.

The word “deductible” is not to be confused with the terms “copay” (a pre-set dollar amount for a service), “coinsurance” (the percentage of medical costs you must pay) , or “premium” (the cost of owning the insurance policy)

Medicare Deductible

Original Medicare requires the beneficiary to pay certain deductibles out of pocket.

• Medicare Part A (hospital coverage) has a deductible of $1132.
• Medicare Part B (doctor and outpatient services) has a deductible of $162.

Those are the only deductibles for Original Medicare (not including prescription coverage).

Medicare Supplement Deductible

Are there deductibles with a Medicare Supplement?

When it comes to Medicare Supplement plans (standardized A-N), the only plan that has its own deductible is High Deductible Plan F.

Most supplemental plans cover the Medicare Part A and Medicare Part B deductibles of $1132 and $162, but some don’t.

For more information visit Medicare Supplements Demystified.

Medicare Supplement plans plans that cover Foreign Travel Emergency pay a benefit of 80% after a $250 deductible. This deductible is specific only to Foreign Travel Emergency.

Medicare Advantage Deductible

Another time you may run into the issue of deductibles, is if you consider enrolling in a Medicare Advantage Plan (usually an HMO). These plans occasionally have a deductible. But it is more common that they don’t.

If you decide to enroll in a prescription drug plan (Medicare Part D), many of those plans have a deductible too.

To summarize, a deductible is a set dollar amount you must pay before the benefits of your plan kick in.

A Medicare Deductible is the amount you pay out-of-pocket before your Medicare benefits kick in ($1132 for part A hospital, and $162 for Part B doctor/outpatient). If you choose a Medicare Supplement or Advantage Plan in addition to Medicare, some or all of these deductibles may be covered.

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