Medicare part B deductible appliing process

Deductible FAQs


Q. How is the Medicare Part B annual deductible applied to payment?

A. For each calendar year, a certain cash deductible exists that must be met before payment may be made by Medicare.

• The deductible for 2012, and until further notice, is $140.00.

Patient expenses are applied toward the deductible based on incurred, rather than paid expenses, and are based on Medicare allowed amounts. Non-covered expenses do not count toward the deductible.

If an individual does not have Part B benefits for an entire calendar year (i.e., insurance coverage begins after the first month of the year), he or she is still subject to the full deductible for the calendar year. Medical expenses they incurred during the year, but before they are actually entitled to Medicare, cannot be applied to the deductible.

Although the date of service generally determines when expenses were incurred, the order in which expenses are applied to the deductible is based on when the bills are actually received.

• Note: Services not subject to the deductible cannot be used to satisfy the deductible.