Deductible
The amount a Medicare beneficiary must pay out-of-pocket before Medicare begins paying its share; Part A and Part B have separate deductibles that reset on different schedules.
Medicare's deductible structure differs meaningfully from commercial insurance. The Part A inpatient deductible ($1,632 in 2024) applies per benefit period, not per year. A benefit period begins when you are admitted as an inpatient and ends after you have been out of the hospital or SNF for 60 consecutive days. A patient hospitalized twice in the same year with a gap of less than 60 days pays only one Part A deductible; hospitalized twice with a 61-day gap pays it twice.
The Part B annual deductible ($240 in 2024) resets on January 1 each year. After meeting the Part B deductible, Medicare pays 80% of the approved amount for most covered services. There is no annual deductible for Part A inpatient hospital coinsurance for days 1–60 — that coinsurance begins only after the per-benefit-period deductible is met.
Medigap plans can eliminate these deductibles. Plan G covers the Part A deductible entirely; the only remaining out-of-pocket cost is the Part B annual deductible ($240). Plan F (unavailable to those eligible after January 1, 2020) covered both deductibles. Understanding deductibles is especially important for dual-eligible beneficiaries on both Medicare and Medicaid, as Medicaid may pay Medicare cost-sharing depending on the state's benefit structure.
Real-World Example
A patient with two separate hospitalizations in one year — each more than 60 days apart — paid the Part A deductible twice ($1,632 × 2 = $3,264), while a patient admitted twice within 45 days paid it only once.