Is there a Medicare deductible?

Is there a Medicare deductible?

Yes, both Part A and Part B have deductibles that will need to be paid by the beneficiary before benefits are covered. 

Medicare Part A Deductible

Medicare Part A covers all inpatient hospital, skilled nursing facility, home health, and hospice care. 

Hospital Care

You will be required to pay the Part A hospital inpatient deductible for any hospital stay. This deductible is $1,340 for the 2018 period. Additionally, you may have other costs for care services received while in the hospital. After your 61st day in the hospital, you will have to start paying a coinsurance cost. 
Your Coinsurance cost is dependent on the length of your hospital stay:
  • Days 61 - 90: Daily coinsurance of $335 in 2018 for each benefit period
  • Days 91 and after: Daily coinsurance of $670 in 2018 for each "lifetime reserve day" in each benefit period. Over your lifetime you have 60 "lifetime reserve days".
  • You can expect to pay all costs once your lifetime reserve days are used up.

Home Healthcare Services

All costs for home healthcare service are covered by Medicare Part A for a limited time and under certain circumstances. If your doctor orders durable medical equipment and supplies as apart of your home healthcare, you will be required to pay 20% of the Medicare-approved amount for the equipment. 

Hospice Care

For hospice care, all costs are typically covered. 
However, there are some exceptions:
  • If you are prescribed medicine while in hospice care, you may need to pay a copayment of no greater than $5 per drug. 
  • If you require inpatient respite services, you may need to cover 5% of the Medicare-approved amount.
  • If you receive hospice care in your home or in a nursing home, you will pay for room and board. 

Medicare Part B Deductible

Medicare Part B covers doctor's office visits, preventive screenings, and durable medical equipment. A deductible will apply for some of these services. The Part B deductible is $183 in 2018. 
Typically, members will be responsible for 20% of the Medicare-approved amount for a healthcare service they meet the deductible. However, each plan is different. Be sure, when choosing a plan, to check with your doctor and your Medicare provider to confirm costs.

Supplemental Insurance

If you need assistance paying your Medicare deductibles, a Medigap insurance plan might be the solution. Medigap insurance offers ten standardized plans that each provide a different level of coverage to help with copayments, deductibles, and coinsurance. These plans are available in every state except Massachusetts, Minnesota, and Wisconsin, where separate standardized plans are available for Medigap. 
Each plan is different. Some will cover Part A, and some will cover Part B, so it is important to learn about each plan and choose the one that best suits your needs. 

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Is there a Medicare deductible?