(212) 705-8745 info@projectmedicare.com

Deductibles are common in all sorts of insurance plans, however, many people fail to explain what they are and how it affects your coverage. So here is the spiel on Medicare deductibles. 

When reviewing your Medicare plan details, the word “deductible” almost always comes up. So how does this deductible amount affect your coverage? Do you only receive coverage once you have reached your deductible or are you always covered regardless? It is important to understand the ins and outs of your coverage, which is why we’ll break it down for you.

What are Deductibles?

When it comes to health insurance, deductibles are a set amount that you must pay before your insurance plan’s coverage starts. The amount is usually a set dollar amount, like $500 but they are sometimes a percentage of the overall insured item. To receive full coverage with your insurance plan, you would first have to reach this limit. 

For example, your home insurance plan has a deductible of $3,000. Your home is damaged and the cost to repair your home is $60,000. Once you pay your deductible of $3,000, the remaining $57,000 would be covered by your plan, depending on your policy and qualifying costs. 

Does this mean for health care services you will have to pay for all other services until you meet your deductible? Not necessarily. Some services may be covered prior to meeting your deductible depending on your health insurance plan. It is always a good idea to do some research and consult with one of our insurance agents here in Project Medicare so that we can explain which services would be covered before meeting your deductible.

Original Medicare Deductible

When it comes to Original Medicare, there are two deductibles that are present. For Medicare Part A, there is an inpatient hospital deductible set at $1,484. Once you paid that much for inpatient health services, your Medicare coverage will start. In Medicare Part B, there is a general deductible of $203 for 2021. Once you paid enough applicable services, Medicare Part B will cover 80% of the Medicare approved amount, and you will have to cover the remaining 20%.

Medicare Advantage and Part D Deductibles

There are also annual deductibles in most Medicare Part C (Medicare Advantage) plans. Since Medicare Advantage plans are offered by private insurance companies, the deductible amount will vary between plans. 

Medicare Part D (Prescription Drug Plan) that pairs with your Original Medicare coverage has deductibles as well. Similar to Medicare Advantage plans, the deductible amount differs from plan to plan. The maximum deductible amount in 2021 for Part D plans is $445.

Project Medicare will always be a source of information to thoroughly explain your health insurance plan and our support does not stop once you’re covered. All clients continue to have access to our team of advisors. Contact us today >>