Skip to Main Content

Print | Bookmark | Font Size: + |

Medicare Deductible & Coinsurance Lookup

Covered Medicare services may be subject to deductible and coinsurance amounts that apply for the calendar year.

  • When a Medicare beneficiary is admitted for a covered Part A inpatient stay, Medicare subtracts the inpatient deductible amount from the amount payable to the facility for inpatient services it provides in a spell of illness. If a beneficiary receives covered Part A services for more than 60 days during a spell of illness, he/she is responsible for a daily coinsurance amount.
  • Medicare beneficiaries who enroll and receive covered Part B services are responsible for an annual deductible and coinsurance amount.

Select a year from the drop-down menu below to view the deductible and coinsurance amounts applicable for that calendar year.

To determine if your patient's services are subject to deductible or coinsurance, verify the beneficiary's eligibility in the myCGS portal or HIPAA Eligibility Transaction System (HETS)External Website.

Select the Year:


2026 Part A – Hospital Insurance (HI)

  • Deductible: $1,736
  • Coinsurance:
    • $434 a day for days 61 – 90
    • $868 a day for days 91 – 150 (lifetime reserve days)
    • $217 a day for days 21 – 100 (in a Skilled Nursing Facility)

2026 Part B – Supplementary Medical Insurance (SMI)

  • Deductible: $283 a year
  • Coinsurance: 20 percent

Reference: MM14279 – Medicare Deductible, Coinsurance, & Premium Rates: CY 2026 UpdateExternal PDF

2025 Part A – Hospital Insurance (HI)

  • Deductible: $1,676
  • Coinsurance:
    • $419 a day for days 61 – 90
    • $838 a day for days 91 – 150 (lifetime reserve days)
    • $209.50 a day for days 21 – 100 (in a Skilled Nursing Facility)

2025 Part B – Supplementary Medical Insurance (SMI)

  • Deductible: $257 a year
  • Coinsurance: 20 percent

Reference: MM13796 – Medicare Deductible, Coinsurance, & Premium Rates: CY 2025 UpdateExternal PDF

2024 Part A – Hospital Insurance (HI)

  • Deductible: $1,632
  • Coinsurance:
    • $408 a day for days 61 – 90
    • $816 a day for days 91 – 150 (lifetime reserve days)
    • $204 a day for days 21 – 100 (in a Skilled Nursing Facility)

2024 Part B – Supplementary Medical Insurance (SMI)

  • Deductible: $240 a year
  • Coinsurance: 20 percent

Reference: MM13365 – Medicare Deductible, Coinsurance, & Premium Rates: CY 2024 UpdateExternal PDF

2023 Part A – Hospital Insurance (HI)

  • Deductible: $1,600
  • Coinsurance:
    • $400 a day for days 61 – 90
    • $800 a day for days 91 – 150 (lifetime reserve days)
    • $200 a day for days 21 – 100 (in a Skilled Nursing Facility)

2023 Part B – Supplementary Medical Insurance (SMI)

  • Deductible: $226 a year
  • Coinsurance: 20 percent

Reference: MM12903 – Update to Medicare Deductible, Coinsurance and Premium Rates for Calendar Year (CY) 2023External PDF

spacer

26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © CGS Administrators, LLC. All Rights Reserved