Medicare Part B Deductible: How It Works and What You Pay

If you’re on Medicare, understanding the Part B deductible is key to knowing what you’ll actually pay when you see the doctor, get lab work, or use other outpatient services.

What is the Medicare Part B deductible?

Medicare Part B helps cover outpatient care, like doctor visits, preventive services, lab tests, durable medical equipment, and some home health care.

The Part B deductible is the amount you must pay out of pocket each year for covered Part B services before Medicare starts paying its share (in most cases).

The deductible amount is set by the federal government and can change each year. Once you’ve met the annual Part B deductible, you typically pay 20% coinsurance for most covered services, and Medicare pays the rest, as long as the provider accepts Medicare assignment.

What counts toward the Part B deductible?

You move toward meeting your deductible each time you receive a covered Part B service that isn’t fully free to you. Common examples include:

• Office visits with your primary care doctor or specialist
• Outpatient hospital services
• Diagnostic tests (like X-rays, MRIs, and lab work)
• Durable medical equipment (such as walkers or oxygen equipment)
• Some home health services, if Part B is paying

What doesn’t usually count toward your Part B deductible:

• Your Part B monthly premium
• Most copays or costs under a Medicare Advantage plan (these follow that plan’s rules)
• Services Medicare doesn’t cover at all

How the deductible affects your bills

Before you’ve met your Part B deductible for the year, you’re generally responsible for 100% of the Medicare‑approved amount for Part B services (after any applicable discounts from providers who accept Medicare).

After the deductible is met:

• Medicare usually pays 80% of the approved amount
• You pay the remaining 20% coinsurance
• Some preventive services may be covered at no cost to you, even if you haven’t met the deductible, as long as certain conditions are met

If you have a Medigap (Medicare Supplement) policy, some plans may cover your Part B coinsurance and, in older discontinued plans, some or all of the Part B deductible. Newer Medigap plans are generally not allowed to cover the Part B deductible itself, but they can still significantly reduce your out‑of‑pocket costs once it’s met.

Key takeaways for planning your costs

• The Part B deductible resets every calendar year, not on your birthday or enrollment date.
• You’ll typically pay more out of pocket at the start of the year until you satisfy the deductible.
• Reviewing your past medical use can help you budget for meeting the deductible early in the year.
• How much you pay after meeting the deductible depends on whether you have Original Medicare only, Original Medicare plus Medigap, or a Medicare Advantage plan, each of which uses its own cost‑sharing structure.

Understanding the Medicare Part B deductible helps you anticipate when your costs will be highest and how other coverage, like Medigap or a Medicare Advantage plan, might help manage what you pay throughout the year.