The Annual Medicare Part B Deductible
Original Medicare, which includes Part A (hospital insurance) and Part B (medical insurance), requires beneficiaries to pay deductibles for both parts. Regarding the question, does Medicare Part B pay deductible?, the answer is no; the beneficiary is responsible for this cost. The standard annual Medicare Part B deductible for 2025 is \$257. This is an annual amount that resets each calendar year. You must meet this deductible before your Part B coverage for medically necessary services, such as doctor visits and outpatient care, begins.
How the Part B Deductible Works
You satisfy the Part B deductible through covered services throughout the year. Once met, you generally pay 20% coinsurance for most Medicare-approved services and items, with Medicare covering the remaining 80%.
What Happens After You Meet the Part B Deductible?
After meeting the annual deductible, you typically pay a 20% coinsurance for most Part B-covered services for the rest of the year. These services include most doctor services, outpatient therapy, Durable Medical Equipment (DME), and mental health care. Original Medicare does not have an out-of-pocket maximum, which leads many to consider supplemental coverage.
Options to Help Pay the Part B Deductible
While Medicare itself doesn't cover your Part B deductible, other plans can help manage these costs.
Medicare Supplement (Medigap) Plans
Medigap policies are sold by private companies to help cover costs not covered by Original Medicare. However, Medigap plans sold to individuals newly eligible for Medicare on or after January 1, 2020, cannot cover the Part B deductible. If you were eligible before this date, you might still be able to purchase plans like Plan C or Plan F that cover the deductible, if available in your state. Newer enrollees might consider plans like Plan G, which covers everything Plan F did except the Part B deductible.
Medicare Advantage (Part C) Plans
Medicare Advantage plans are offered by private insurers as an alternative to Original Medicare. They must cover at least what Original Medicare covers but can have different cost structures. Some Medicare Advantage plans offer a \$0 medical deductible, meaning you wouldn't pay the standard Part B deductible. Other plans may have a deductible or use copayments. Medicare Advantage plans also have an annual out-of-pocket maximum.
Comparison: Deductible Coverage by Plan Type
| Plan Type | Pays Part B Deductible? | How it Works |
|---|---|---|
| Original Medicare | No | The beneficiary pays the annual deductible before coverage begins. |
| Medigap (for new enrollees) | No | By law, plans sold to new beneficiaries on or after January 1, 2020, do not cover the Part B deductible. |
| Medigap (for pre-2020 enrollees) | Sometimes | If eligible before 2020, plans like C or F may cover it if available. |
| Medicare Advantage (Part C) | Sometimes | Varies by plan; some offer a \$0 medical deductible. |
Services Covered at 100% Under Part B
Some preventive services are covered at 100% by Medicare Part B, meaning no deductible or coinsurance applies. These include annual wellness visits, flu shots, pneumococcal shots, COVID-19 vaccines, and certain screenings.
Conclusion
To reiterate, Original Medicare Part B requires the beneficiary to pay an annual deductible before standard coverage begins. While Medigap plans for new beneficiaries do not cover this cost, Medicare Advantage plans or government assistance programs can offer alternatives for managing healthcare expenses. Understanding your specific coverage is essential for managing costs effectively.
For more detailed information, consult the official Medicare.gov website to review costs and plan options.
