Medicare Deductible / Coinsurance Look-Up
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/coinsurance, verify the beneficiary's eligibility in the myCGS portal, Interactive Voice Response (IVR) system or HIPAA Eligibility Transaction System (HETS).
Select the Year:
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 Update
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) 2023
2022 Part A Hospital Insurance (HI)
- Deductible: $1,556.00
- Coinsurance:
- $389.00 a day for 61st – 90th day
- $778.00 a day for 91st – 150th day (lifetime reserve days)
- $194.50 a day for 21st – 100th day (Skilled Nursing Facility coinsurance)
2022 Part B – Supplementary Medical Insurance (SMI)
- Deductible: $233.00 a year
- Coinsurance: 20 percent
Reference: MM12507 – Update to Medicare Deductible, Coinsurance and Premium Rates for Calendar Year (CY) 2022
2021 Part A Hospital Insurance (HI)
- Deductible: $1,484.00
- Coinsurance:
- $371.00 a day for 61st – 90th day
- $742.00 a day for 91st – 150th day (lifetime reserve days)
- $185.50 a day for 21st – 100th day (Skilled Nursing Facility coinsurance)
2021 Part B – Supplementary Medical Insurance (SMI)
- Deductible: $203.00 a year
- Coinsurance: 20 percent
Reference: MM12021 – Update to Medicare Deductible, Coinsurance and Premium Rates for Calendar Year (CY) 2021
2020 Part A Hospital Insurance (HI)
- Deductible: $1,408.00
- Coinsurance
- $352.00 a day for 61st – 90th day
- $704.00 a day for 91st – 150th day (lifetime reserve days)
- $176.00 a day for 21st – 100th day (Skilled Nursing Facility coinsurance)
2020 Part B – Supplementary Medical Insurance (SMI)
- Deductible: $198.00 a year
- Coinsurance: 20 percent
Reference: MM11542: Update to Medicare Deductible, Coinsurance and Premium Rates for Calendar Year (CY) 2020