January 15, 2025
Top Medicare Deductible Questions
If you’re on Medicare and have questions about your deductible, you’re not alone. Each year, Medicare beneficiaries face different deductibles depending on the type of coverage they have. Knowing when and how your deductible resets can help you budget for…
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If you’re on Medicare and have questions about your deductible, you’re not alone. Each year, Medicare beneficiaries face different deductibles depending on the type of coverage they have. Knowing when and how your deductible resets can help you budget for the year ahead and avoid unexpected expenses. At US MED®, we work daily with both Medicare beneficiaries and providers. In addition to providing you with reliable medical supplies, one of our goals is to help you navigate the complexities of Medicare, including understanding your deductible and coverage options. In this guide, we answer the top Medicare deductible questions and discuss why you should maximize your benefits before the end of the year.
Table of Contents
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- What is a Medicare deductible?
- When does my Medicare deductible reset?
- Why should I maximize my Medicare deductible before the end of the year?
- Once I meet my Medicare deductible, how much do I pay?
- Does my income affect my Medicare deductible?
- How do I track my Medicare deductible?
- How do I get a Medicare deductible statement, or Medicare Summary Notice (MSN)?
- What is the maximum out-of-pocket for Medicare in 2025?
- What is the benefit period for Medicare Part A?
- Can I get diabetes supplies with Medicare?
- Types of Medicare Plans
- Medicare Deductibles by Plan for 2024 and 2025
- Medicare Glossary
- Why Choose US MED®?
1. What is a Medicare Deductible?
Like other health insurance plans, a Medicare deductible is the amount of money you must pay out-of-pocket before the Medicare coverage plan begins to pay a portion of the cost. For example, if your deductible is $300, you must pay $300 in healthcare costs before your Medicare plan begins to share the cost.
2. When does my Medicare deductible reset?
Medicare deductibles reset annually on January 1st. Your deductible resets whether or not you have met it and it does not roll over. For example, if your deductible was $300 and you only paid $100 out-of-pocket by year-end, you will still have to meet the full deductible the following year.
Important to note: This does not apply to Medicare Part A.
3. Why should I maximize my Medicare deductible before the end of the year?
Most Medicare deductibles reset annually on January 1st. Once you’ve met your deductible, you’ll only need to pay coinsurance or copayments for additional services until you reach your out-of-pocket maximum for the year. After meeting the deductible, beneficiaries pay less for covered services and supplies.
If you are covered by Medicare Part D and reach your out-of-pocket maximum for the year, you pay nothing until the year ends. Therefore, it’s a great time to stock up on recurring medical necessities like insulin pumps and supplies. It’s important to stock up on these items before the end of the year, because once the deductible resets, you’ll have to begin paying out of pocket again.
4. Once I meet my Medicare deductible, how much do I pay?
Under Part B, once you meet your deductible, you’ll pay 20% of your healthcare costs, while Medicare will cover 80%.
5. Does my income affect my Medicare deductible?
No, your income does not affect your Medicare deductible. However, your income does affect your Medicare premium, which is the monthly rate you pay for certain Medicare plans.
6. How do I track my Medicare deductible?
You can track your Medicare deductible status with a Medicare deductible statement, also known as a Medicare Summary Notice (MSN). The MSN also provides information for your claims.
7. How do I get a Medicare deductible statement or Medicare Summary Notice?
You can get your Medicare deductible statement online at MyMedicare.gov. Or call 1-800-MEDICARE to receive a hard copy via mail. Your Medicare deductible statement shows you what portion of your deductible you’ve met so you can plan your spending accordingly.
8. What is the maximum out-of-pocket for Medicare in 2025?
The out-of-pocket maximum for Medicare Part D is $2,000.00 in 2025. For Medicare Advantage plans, the in-network out-of-pocket maximum is $9,350.00 in 2025.
Both Part A and Part B do not have out-of-pocket maximums.*
9. What is the benefit period for Medicare Part A?
The benefit period for Medicare Part A begins the day you are admitted to a hospital. It ends once you’ve been out of the hospital for 60 consecutive days. If you are admitted again after 60 days, a new benefit period begins, and the deductible will apply again. Therefore, unlike Part B and Part D, under Part A, you may have multiple deductible periods per year. However, the deductible rate will remain the same within that year.+
10. Can I get diabetes supplies with Medicare?
Yes! Many diabetes supplies are considered durable medical equipment (DME) and are covered by Medicare Part B. This includes testing supplies like lancets and test strips, CGMs, and more. Insulin, insulin pumps, and pens are covered under Medicare Part D. Our helpful guide provides a breakdown of what diabetic supplies are covered by Medicare.
Types of Medicare Plans
The most common types of Medicare plans are Part A (hospital insurance), Part B (medical insurance), and Part D (prescription drug coverage). Each of these plans have different deductibles. The deductibles change from year to year, so it’s important to know what your new deductible is starting January 1st.
Medicare Deductibles by Plan for 2024 & 2025
2024
- Medicare Part A Deductible 2024: $1,632.00
- Medicare Part B Deductible 2024: $240.00
- Medicare Part D Deductible 2024: Up to $545.00 (Plans may vary, but do not exceed this amount. It is important to note that some Medicare Part D plans, do not have a deductible at all)
2025
- Medicare Part A Deductible 2024: $1,676.00
- Medicare Part B Deductible 2024: $257.00
- Medicare Part D Deductible 2024: Up to $590.00 (Plans may vary, but do not exceed this amount. It is important to note that some Medicare Part D plans, do not have a deductible at all)+
Medicare Glossary
- Deductible: The amount of money you must pay on healthcare services, prescriptions, or medical supplies before Medicare pays a portion of your healthcare costs.
- Premium: The monthly payment you make to have certain Medicare coverage. Not all plans have a premium.
- Out-of-Pocket Maximum: The maximum amount of money you have to pay out-of-pocket for services within one year. This mostly applies to Medicare Advantage plans and Part D.
- Medicare Summary Notice: A document with your claim information and deductible status.
- Medicare Part A: Medicare’s hospital insurance.
- Medicare Part B: Medicare’s health insurance.
- Medicare Part D: Medicare’s prescription drug coverage.
- Medicare Advantage: A bundled Medicare approved plan that is offered through a private company as an alternative to standard Medicare.^
- Copayment: The portion of a medical bill that the beneficiary pays once they’ve met their deductible.
Why Choose US MED
US MED® is a top provider of diabetes supplies. We offer an extensive selection of products with exceptional customer service. We make it easy for Medicare beneficiaries to get the diabetic supplies they need easily and efficiently. We accept Medicare and can bill Medicare directly for eligible items.
One of the unique benefits of choosing US MED® is that we provide a 90-day supply for Medicare beneficiaries, meaning you only need to reorder four times a year instead of twelve. If you’re unsure about what diabetic supplies are covered by Medicare or which products are right for you, our team is here to assist. Contact us today and let us help you make the most of your Medicare benefits!