How can we get you out of the deductible?
Let’s make it easy to understand. A deductible is the amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself. Source: Healthcare.gov
Medicare has a deductible we all pay. In 2023, you pay $226 for your Part B deductible. After you meet your deductible for the year, you typically pay 20% of the Medicare-Approved Amount if Medicare is the only insurance you are enrolled in. Source: Medicare.gov Part B deductible and co-insurance, 1/30/2023
With Medicare only and after you meet your deductible for the year, you typically pay 20% of the Medicare-Approved Amount. That is a lot of money. On a small, $10,000 procedure, you owe $2,000.
When you enroll in a Medicare Supplement plan after January 2021, you will pay the Part B deductible. For those eligible or enrolled before January 2021, there are select plans that cover the deductible.
With a Medicare Supplement plan, you will also need a Prescription Drug Plan. Unlike Medicare Advantage, Medicare Supplements do not include prescription drugs. Most prescription drug plans have a deductible.
Are you enrolled in a Medicare Advantage plan? You do pay the Part B deductible through your co-pays and co-insurance payments. Most plans include prescription drug coverage and may or may not include a prescription drug deductible.
Medicare Advantage plans Maximum-out-of-pocket?
There are Medicare Advantage plans that have deductibles, many do not. They all have a Maximum-out-of-pocket limit.
So what is a Maximum-out-of-pocket? The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, co-payments, and coinsurance for in-network care and services, your health plan pays 100% of the costs of covered benefits.
The out-of-pocket limit doesn’t include:
- Your monthly premiums
- Anything you spend for services your plan doesn’t cover
- Out-of-network care and services
- Costs above the allowed amount for a service that a provider may charge
The out-of-pocket limit for Marketplace plans varies, but can’t go over a set amount each year. Source: Healthcare.gov, 1/30/2023