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The 2019 Medicare Part B Deductible: What It Is and How You Can Get Coverage

Christian Worstell by Christian Worstell    |    Published Oct 03, 2019    |    Reviewed by John Krahnert

The Medicare Part B deductible increased from 2018 to 2019. The 2019 Part B deductible is $185 per year (up from $183 in 2018).

This guide also explores the Part B deductible and some of the other 2019 Medicare Part B costs you may face, as well as ways you can get coverage for some of your Medicare Part B costs.

A woman smiles while she speaks with her doctor

What Is the 2019 Medicare Part B Deductible?

As mentioned above, the annual Medicare Part B deductible for 2019 is $185. So what exactly does that mean?

You are responsible for the first $185 worth of services or items that are covered by Medicare Part B that you receive in the calendar year of 2019.

After you have paid $185 out of your own pocket, your Part B coverage will kick in.

Part B covers:

  • Qualified medical care, such as doctor’s office visits and procedures
  • Certain preventive care
  • Some durable medical equipment (DME)

Medicare Supplement Insurance (Medigap) Plan F and Plan C both provide full coverage for the 2019 Part B deductible. However, both plans will not be available to new Medicare beneficiaries after Jan. 1, 2020. If you already have Medicare, you may be able to enroll in Plan C or F if either is available in your area.

What Happens After You Meet the Part B Deductible?

After you reach your Medicare Part B deductible, you will typically pay a 20% coinsurance for all services and items that are covered by Part B for the remainder of 2019.

On Jan. 1, 2020, your deductible will reset, and you will have to pay the 2020 Medicare Part B deductible before your Part B coverage kicks in for 2020.

The 20% share that you must pay after reaching the deductible is calculated using the Medicare-approved amount.

This is the amount that Medicare has determined it will pay for a particular service or item. If your health care provider accepts Medicare assignment, it means they accept Medicare reimbursement as payment in full for the covered services they provide.

Each type of standardized Medigap plan provides full or partial coverage of the Part B coinsurance or copayment.

An Example of the Medicare Part B Deductible

Here’s an example that illustrates how the 2019 Medicare Part B deductible works:

  • You come down with an illness in March, 2019. You visit your doctor for an evaluation, and you are billed $120 for the visit. This is the first medical care covered by Part B you have received in 2019.
  • You will be responsible for the full $120 for your appointment since you have not yet satisfied your 2019 Part B deductible.
  • In July, you injure your knee and schedule another appointment with your doctor. This time you are billed $150 for the appointment.
  • You will be responsible for paying the first $65 of the $150 for the appointment out of your own pocket, because that is how much is left on your deductible.
  • After the $65 is paid, you have reached $185 in out-of-pocket spending for covered Part B services in 2019. You have reached your deductible and you will now be responsible for any Part B coinsurance charges.
  • There is still $85 remaining for your doctor’s visit ($150 total charge minus the $65 you paid out of pocket). You will typically be required to pay 20% of that amount, which comes out to $17.

Should you need any more health care for the remainder of 2019, you will only have to pay 20% of the Medicare-approved amount for anything that is covered under Part B (as long as you visit health care providers who accept Medicare assignment).

There is no annual out-of-pocket spending limit for Medicare Part A or Part B.

What Are Other Part B Costs in 2019?

There are several types of Part B costs you may face in 2019, such as:

2019 Medicare Part B Premium

The standard premium for Medicare Part B in 2019 is $135.50 per month, although some people might pay more than that amount.

The Part B premium is based on your reported income from two years prior. So that means your 2019 premiums are based off of your reported income from 2017.

Most people pay the standard Part B premium amount, but higher income earners may pay a higher amount called the Income-Related Monthly Adjusted Amount, or IRMAA.

The table below shows what Part B beneficiaries will typically pay for their premium in 2019.

2017 Individual tax return 2017 Joint tax return 2017 Married and separate tax return 2019 Part B premium
$85,000 or less $170,000 or less $85,000 or less $135.50
More than $85,000 and up to $107,000 More than $170,000 and up to $214,000 N/A $189.60
More than $107,000 up to $133,500 More than $214,000 up to $267,000 N/A $270.90
More than $133,500 up to $160,000 More than $267,000 up to $320,000 N/A $352.20
More than $160,000 up to $500,000 More than $320,000 up to $750,000 More than $85,000 up to $415,000 $433.40
More $500,000 More than $750,000 More than $415,000 $460.50

Medicare Part B Excess Charges

When a health care provider accepts Medicare assignment, it means they have agreed to accept the Medicare-approved amount as full payment.

When a provider does not accept assignment, it means they will still treat Medicare patients, but they do not accept the Medicare-approved amount as full payment.

These providers reserve the right to charge up to 15% more than the Medicare-approved amount for their service or item, and the beneficiary is responsible for paying that extra amount.

This extra amount is called an “excess charge.”

Medigap Plan F and Plan G both cover Part B excess charges in full.

Medigap Plans Can Cover Some Medicare Part B Costs

Medigap plans help pay for some of the out-of-pocket expenses associated with Medicare Part A and Part B.

Speak with a licensed insurance agent today to learn about Medicare Supplement Insurance plans available in your area that may be able to help cover your Medicare Part B deductible and other costs.

 

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Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.

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