Medicare coverage5 Important points about Medicare Part A and B coverage gaps
Medicare plans have deductibles just as individual health insurance plans do. Both Original Medicare and, typically, Medicare Advantage Plans, require you to meet a deductible, an amount you pay for healthcare or prescriptions before your health insurance coverage begins to pay.1
Medicare Part A, the hospital insurance program, and Medicare Part B, which covers doctor services among other things, each have a deductible, which is one type of out-of-pocket cost paid.
The deductibles listed here are for Original Medicare. Medicare Advantage Plans, which may offer additional benefits, have different costs depending on the plan.2
Deductibles for both Original Medicare Part A and Part B will increase in 2017.3
Medicare Part A deductible
Unlike with Medicare Part B, you might have to pay more than one deductible in a year for Medicare Part A, which covers inpatient care in a hospital or skilled nursing facility. Original Medicare requires that you pay a deductible for each benefit period in a year.
A benefit period begins the day you're admitted to a hospital or skilled nursing facility and ends when you haven't spent the night in one of them for 60 consecutive days. If you're admitted to a hospital or skilled nursing facility after one benefit period has ended, then a new one begins, and you have to pay another deductible.
In 2016, the Medicare Part A deductible for each benefit period is $1,288. In 2017, the deductible will increase to $1,316 per benefit period.4 That's less than the average cost of a single night in a U.S. hospital.5
Medicare Part B deductible
Medicare Part B covers most doctor services, including those you receive while hospitalized, as well as outpatient therapy and durable medical equipment, which is equipment your doctor prescribes because it is medically necessary. Such equipment ranges from blood sugar monitor test strips for people with diabetes to walkers to hospital beds.
The Part B deductible for 2016 is $166 for the year; in 2017 it will rise to $183.6
Medigap insurance to cover deductibles
You can buy private Medicare supplemental—or Medigap—insurance to cover traditional Medicare's out-of-pocket expenses, including the hospital deductible.
However, if you're in a Medicare Advantage Plan, you cannot use Medigap insurance. In fact, it is illegal to sell Medigap insurance to someone in a Medicare Advantage Plan.
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