Medicare Q & A

Q:  I would like to know the deductible of my Medicare.

A:  Medicare has three Parts: A (hospital), B (doctors and hospital outpatient) and D (prescription drugs).  Each has a deductible and each increases every year.  In 2007 the Medicare deductibles (annually) are:

Part A - $992
Part B - $131
Part D - $265

A deductible is the amount of money you must pay before your coverage starts.  Many Medicare supplements (Medigap policies), Medicare Advantage plans, and drug plans cover Medicare's deductible as part of the coverage you purchase.  Medigap polices "B" through "J" pay the Part A dedictible, and Plans "C", "F" and "J" also cover the Part B deductible.  Medicare Advantage Plans and prescription drug plans may or may not have a yearly deductible depending on the type of plan you choose.  There are also federal and state government programs for low-income seniors that provide assistance for this cost.

The Part B and Part D deductible period starts on January 1 of each year and ends on December 31.  If you were healthy during the year, but require doctor's services in November for the first time and the charge is $100, then you (or possibly your supplemental insurance plan) will have to pay that charge.  If you don't see the doctor again until January, you start a whole new deductible period.  If he charges you $100 again, then you or your insurer will pay the $100 again.

The Part A deductible, however, is charged "per spell of illness" and it's feasible that you could have to pay it more than one time in a year should you require multiple hospitalizations the same year.

Generally, you pay higher premiums for plans that have no deductibles. All too often, though, Medicare consumers pay premiums that far exceed the cost of the deductible because they don't do the math.  Having a plan that pays the Part A (hospital) deductible of $992 makes sense, because just one trip to the hospital could take your entire month's Social Security benefit.

Having a plan that covers Part D deductible generally is the better choice if you must take a lot of monthly prescriptions or if you have high drug costs.  If you only require a few prescriptions or low cost generics, you might find that by going ahead and paying the deductible you recover that cost in much lower premiums.  The only way to tell is by using Medicare's Drug Plan Finder to compare plan costs based on the prescriptions you take.

Medicare Advantage plans require very careful scrutiny of potential costs.  Some plans have lured seniors with low premiums and deductibles, only for enrollees to discover high undisclosed costs later.

To learn more about Medicare deductibles visit online at or call toll free at 1-800-MEDICARE (1-800-633-4227).

August 2007