Medicare Part B Deductible for 2023
The Medicare Part B deductible has increased in amount from the previous year.
For Medicare recipients, Part B coverage is known as your medical insurance.
It helps to cover costs for doctor services, outpatient therapy, durable medical equipment, and other medically necessary services and preventive services not covered by Part A.
The Medicare Part B deductible is the amount you must pay toward Part B covered services before your Medicare coverage kicks in and pays 80% of the Medicare-approved amount (while you pay the remaining 20%).
Each year the Part B deductible amount is adjusted in accordance with the Social Security Act.
The 2023 Medicare Part B deductible amount has decreased from the 2022 amount, which we will cover here.
What Is the Part B Deductible for 2023?
The Part B deductible for 2023 is $226.00.
This amount has decreased by $7 from the Part B deductible for 2022, which was $233.00.
As you consider your Medicare costs for 2023, it’s helpful to know the Part B deductible amount.
Once you have paid this amount for services covered by Medicare Part B, your Part B coverage will begin paying 80% of the covered services going forward for the year.
In other words, once you pay $226.00 in out-of-pocket expenses for Part B services in 2023, you will then be charged a 20% coinsurance going forward (while Medicare covers the rest).
Important Change to Part B Deductible Coverage
Since 2020, Medicare beneficiaries are no longer able to purchase Medigap plans that pay the cost of their Part B deductible.
This is the result of Congress passing the Medicare Access and Chip Reauthorization Act (MACRA).
Previously, Medicare enrollees were able to purchase Medigap plans to help pay for the out-of-pocket Part B deductible cost of Original Medicare.
The two Medigap plans that included coverage of the Part B deductible, Plan C and Plan F, are no longer available for those newly eligible to Medicare after January 1, 2020.
Note, however, that if you purchased either of these Medigap plans prior to January 1, 2020, your coverage will be unaffected and continue as normal.
Similarly, if you became eligible for Medicare prior to this date, you still have the option to purchase either Medigap Plan C or Plan F even if you have not yet done so.
How Does the Medicare Part B Deductible Work?
To begin, let’s start with how an insurance deductible works.
When you see an amount listed as your insurance deductible, this is the amount that you must pay out-of-pocket before your insurance coverage kicks in and begins to help with your costs.
Note, that your deductible is only met when the out-of-pocket costs go toward care or services specifically covered by that insurance.
So, for example, with your Medicare Part B coverage, these services might include:
Most doctor services (including hospital inpatient doctor services)
Durable medical equipment (such as wheelchair, walker, or hospital bed)
Once you have met the deductible (i.e. paid the specified deductible amount toward covered services), you will only be required to pay a copayment or coinsurance amount for those covered services for the remainder of the year.
Now, let’s apply this directly to your Medicare Part B deductible for 2023, which is $226.
Once you have paid $226.00 in out-of-pockets costs toward care or services specifically covered by Medicare Part B, you will then only pay 20% of the costs for those covered services going forward.
In other words, once you’ve met your Part B deductible (paid $226 for Part B covered care), Medicare will cover 80% of Part B costs for the rest of the year, while you are responsible for the remaining 20%.
What Does Medicare Part B Cover?
If you’re enrolled in Medicare Part B, you receive coverage for both medically necessary services and preventive services.
This includes some of the more expensive services you might experience during a hospital stay, such as surgery, radiation, diagnostic imaging, chemotherapy, and dialysis, among others.
Part B covers preventive medical services like ambulance rides, doctor visits, screenings, and diagnostic tests.
It also covers a number of preventive care measures such as flu shots, colonoscopies, and mammograms.
Medically Necessary Services:
Medically necessary services and supplies are those used for diagnosis and treatment of medical conditions.
These services and supplies must meet the accepted standards of medical practice.
This includes the use of medical equipment like wheelchairs, hospital beds, and oxygen equipment.
Preventive services are those that prevent illness or detect it early enough for optimal treatment.
This includes diagnostic tests like MRIs, EKGs, CT scans, and X-rays. It also applies to covered screenings such as pap tests, HIV screening, glaucoma tests, hearing tests, diabetes screening, and colorectal cancer screenings.
If your healthcare provider accepts assignment, you often don’t have to pay anything for these preventive services.
How to Tell If Part B Covers What You Need
1. Consult with your doctor or health care provider to find out if Medicare covers your needed services or supplies.
In some cases, you may require something that is typically covered by Medicare but your provider isn’t sure if coverage will extend in your specific situation.
If this happens, you can sign a notice that says you may be required to pay for the test, item, or service.
2. You can also always search your Medicare coverage by test, item, or service at this Medicare.gov Coverage Page.
Remember: Your Medicare coverage will be based on federal and state laws, national coverage decisions by Medicare, and local coverage decisions made by Medicare claims processors in each state.
To get a fuller understanding of your Medicare Part B costs, coverage, and more, read our Comprehensive Guide to Medicare Part B.