Q: Did the Medicare Part B deductible increase for 2019?
A: Yes. After remaining unchanged in 2018, the Part B deductible increased by $2 for 2019, to $185.
[Note that the monthly premium for Part B also increased for most enrollees for 2019, to $135.50/month. 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 2031 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.
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 will no longer be available to newly eligible enrollees 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 or retiree health benefits from an employer generally don’t have to pay the Part B deductible, as the other coverage picks up the tab.
- 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, B, and 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 percent of Original Medicare beneficiaries only have Medicare Parts A and B. They don’t have Medigap coverage, retiree health benefits from a former employer, or Medicaid. These enrollees have to pay the full Part B deductible if and when they need services that are covered under Medicare Part B. For 2019, that deductible is $185.
After the enrollee pays the deductible, Medicare Part B generally covers 80 percent of the Medicare-approved amount for covered services, and the enrollee pays the other 20 percent. But again, supplemental coverage can pay some or all of this 20 percent 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
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.