Medicare Part B Deductible: How it works

Medicare Part B (Medical Insurance) covers doctor and other health care providers’ services and outpatient care. Medicare Part B also covers durable medical equipment, home health care, and some preventive services.  Before Part B pays, you have to meet the Medicare Part B deductible first, then Medicare Part B pays the 20%.

How much is it?

The Medicare Part B deductible currently is $198 per year (2020).  After your deductible is met, you typically pay 20% of the Medicare-approved amount.  If you have a Medigap insurance plan, it pays the 20% for you.  This applies for most doctor services, including most doctor services while you’re a hospital inpatient, outpatient therapy, and durable medical equipment.

Some Medigap insurance plans will also pay this $198 for you, but if not, you have to pay it.  I had a client recently ask me who she is supposed to pay the Medicare Part B deductible to, since she has several doctors.  The answer is below.

How do I pay it?

Here’s the answer and what’s recommended.  The Medicare Part B deductible is applied on a basis of first claim received, first claim applied to the deductible.  This means that when the New Year starts, Medicare will apply your first claim or claims received to your deductible until the full deductible has been satisfied.

One thing to note is that the first claim Medicare receives may or may not necessarily be from the first doctor you saw in the New Year.

Your Medicare Summary Notice will show which provider’s services Medicare applied to the deductible, the amount of the deductible owed to that provider and how much of the deductible has been met for the year.  You will receive a bill from the provider for the amount owed.

Once the deductible has been fully satisfied the subsequent summaries will indicate your deductible has been met for the year and Medicare will start to pay its portion of new claims as they come in.

Your provider may request the deductible amount at the time of your visit but because the status of your deductible may not be known at the time of your appointment.  I suggest you wait until you receive your summary notice before paying anything.  Have the provider bill you before you pay the amount and the amount billed should be the same as the amount shown on the summary notice.

Need more information?

If you would like more information on this or to speak with me please call me directly at (888) 901-4870 or you can leave me your information by visiting the contact us page.

This article covers the Medicare Part B deductible and the Medicare Part B premium 2020.  The standard amount is $144.60 per month paid to Medicare.  The 2020 Medicare changes are that the current deductible amount for Part B is $198, calendar-year.  2020 Medicare Part B deductible and the Medicare Part B premium 2020.