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Home › Glossary › Deductible

Deductible

by David Bynon, June 6, 2021

What are the Medicare Deductibles?

A deductible is an amount a beneficiaryA person who has health care insurance through the Medicare or Medicaid programs. must pay for their health care expenses before the health insurance policy begins to pay its share.

In the federal Medicare programMedicare is a federal health insurance program for people ages 65 and older and people with certain disabilities. there are four different types of deductibles:

  1. Medicare Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care. Deductible: This Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage. deductible is based on a benefit periodA benefit period is a method used in Original Medicare to measure a beneficiaries use of hospital and skilled nursing facility (SNF) services. With each new benefit period, the beneficiary is charged a new benefit.... The beneficiary pays the deductible for each inpatient benefit period used. If a beneficiary has three unrelated inpatient benefit periods in a year, the Part A deductible is paid three times.
  2. Medicare Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services. Deductible:  This Original Medicare deductible is annual. The beneficiary pays all outpatient medical costs until the deductible is met.
  3. Medicare Part CMedicare Part C is Medicare's private health plan option. Also known as Medicare Advantage, Medicare Part C plans are a type of Medicare health plan offered by companies that contract with Medicare to provide all... Deductible: Also known as Medicare AdvantageMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B)., most Part C plans do not have an annual deductible for the health plan portion of the plan, but may have deductibles for extra benefits, such as a Part D plan.
  4. Medicare Part D Deductible: Most Medicare prescription drug plansMedicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... have an annual deductible that must be paid before the plan starts paying its share at the pharmacy.

Deductible amounts can change every year. In addition to the deductible, most health plans have additional out-of-pocket costsOut-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments., including copaysA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service. and coinsuranceCoinsurance is a percentage of the total you are required to pay for a medical service. .

In long-term carea variety of services that help people with their medical and non-medical needs over a period of time. Long-term care can be provided at home, in the community, or in various types of facilities, including... insurance, a deductible is also known as the elimination period

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