What is a Deductible?
A deductible is an amount a beneficiary 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:
- Medicare Part AMedicare Part A is hospital inpatient coverage for people with Original Medicare, whereas Part B is medical coverage for doctor visits, tests, etc.... 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 period. 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.
- Medicare Part BMedicare Part B is medical coverage for people with Original Medicare. It covers doctor visits, specialists, lab tests and diagnostics, and durable medical equipment. Part A is for hospital inpatient care.... Deductible: This Original Medicare deductible is annual. The beneficiary pays all outpatient medical costs until the deductible is met.
- Medicare Part C 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.
- Medicare Part D Deductible: Most Medicare prescription drug plansMedicare Part D is Medicare's prescription drug plan program. Plans are offered by private insurance companies and cover outpatient prescriptions.... 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 (aka, out-of-pocket medical expenses) are costs that a beneficiary must pay because their health insurance does not cover them. Out-of-pocket costs are found in the deductibles, copayments, and coinsurance outlined in each health..., 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 care insurance, a deductible is also known as the elimination period