Medicare Deductibles and Copayments refer to the out-of-pocket costs that beneficiaries are responsible for paying under the Medicare program. Here are some key features:
• Deductibles: A deductible is the amount that a beneficiary must pay out-of-pocket before Medicare starts to pay its share of the costs. Medicare has deductibles for both Part A (hospital insurance) and Part B (medical insurance). In 2021, the Part A deductible is $1,484 per benefit period, and the Part B deductible is $203 per year.
• Copayments: A copayment is a fixed amount that a beneficiary pays for a covered service after they have met their deductible. For example, under Part B, beneficiaries typically pay 20% of the Medicare-approved amount for most doctor services and outpatient therapy services.
• Cost-sharing: Cost-sharing refers to the portion of the cost of covered services that beneficiaries are responsible for paying. In addition to deductibles and copayments, cost-sharing may include coinsurance (a percentage of the cost of a service), and other fees.
• Limits on out-of-pocket costs: Medicare also has a limit on the amount that beneficiaries can be required to pay in out-of-pocket costs for covered services in a given year. In 2021, the out-of-pocket limit for Part A and Part B is $7,550.
Overall, Medicare Deductibles and Copayments are designed to ensure that beneficiaries share in the cost of their healthcare services, while also providing some protection against catastrophic expenses.
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