What is the Medicare Part B deductible for 2023?
A: The Part B deductible decreased by $7 for 2023, to $226. This was the first time in more than a decade that the Part B deductible had dropped from one year to the next.
(Note that the monthly premium for Part B also decreased for 2023, to $164.90/month for most enrollees. This is different from the deductible though; the premium is the amount you pay every month in order to have coverage, whereas the deductible is the amount you pay if and when you need medical care covered by Part B.)
The deductible for Part B was steady at $147 from 2013 to 2015 (this was lower than it had been in 2010-2011; see below for a list of Part B deductible amounts by year). It then increased to $166 in 2016 – far less than the $223 it would have been without the budget that Congress passed in November 2015, which included a loan for Medicare.
The Part B deductible increased again for 2017, to $183, and remained unchanged for 2018. For 2019, it increased slightly, to $185. And for 2020, it increased by another $13, to $198. The $5 increase in 2021 pushed it over $200 for the first time, with the 2021 Part B deductible reaching $203. And for 2022, the increase was fairly significant, pushing the deductible to $233.
The larger-than-average increase in the Part B deductible and premiums for 2022 was due in part to uncertainty about how Aduhelm, a new Alzheimer’s medication, might affect Part B spending. But costs for that (and other Part B services) ended up being lower than projected in 2022, allowing CMS to reduce the Part B deductible and premiums for 2023.
Does everyone have to pay the Part B deductible?
Some Medicare enrollees aren’t directly responsible for the Part B deductible:
- Medigap plans C and F cover the deductible (which is why those plans are no longer available to people who become newly eligible for Medicare after the end of 2019, under the terms of the Medicare Access and CHIP Reauthorization Act; the idea is that there will be less unnecessary utilization of health care if all Original Medicare enrollees are subject to the Part B deductible, but critics argue that it could also hinder access to necessary care).
- Enrollees who have Medicaid, employer-sponsored health coverage, or retiree health benefits from an employer generally don’t have to pay the Part B deductible, as the other coverage picks up some or all of the cost.
- Some Medicare Advantage plans have no deductibles and low copays (Medicare Advantage enrollees pay the Part B premium plus the Medicare Advantage premium, and then the Medicare Advantage insurer wraps the Part A and B (and in most cases, D) benefits into one plan for the enrollee, with cost-sharing that can differ greatly from the standard Original Medicare cost-sharing).
But according to a Kaiser Family Foundation analysis, about 19% of Original Medicare beneficiaries only have Medicare Parts A and B. They don’t have Medigap coverage, employer-sponsored coverage, retiree health benefits from a former employer, or Medicaid. These enrollees — along with beneficiaries who have a Medigap plan other than C or F — have to pay the full Part B deductible if and when they need services that are covered under Medicare Part B. For 2023, that deductible is $226.
After the enrollee pays the deductible, Medicare Part B generally covers 80% of the Medicare-approved amount for covered services, and the enrollee pays the other 20%. But again, supplemental coverage can pay some or all of this 20% cost, leaving the enrollee with far lower out-of-pocket costs than they would have under Part B by itself.
Part B deductible by year
These amounts are indexed annually, after being set by the Medicare Modernization Act in 2005:
- 2005: $110
- 2006: $124
- 2007: $131
- 2008: $135
- 2009: $135
- 2010: $155
- 2011: $162
- 2012: $140 (a decrease)
- 2013: $147
- 2014: $147
- 2015: $147
- 2016: $166
- 2017: $183
- 2018: $183
- 2019: $185
- 2020: $198
- 2021: $203
- 2022: $233
- 2023: $226 (a decrease)
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.
Tags: deductible, Medicare Part B
