Part B Annual Deductible

20.2 - Part B Annual Deductible (Rev. 12980; Issued:11-25-24; Effective: 01-01-25; Implementation: 01-06-25) In each calendar year, a cash deductible must be satisfied before payment can be made under SMI. (See 20.4 of this chapter for exceptions.) Calendar Year Deductible 1966 – 1972 $50 1973 – 1981 $60 1982 – 1990 $75 1991 – 2004 $100 2005 $110 2006 $124 2007 $131 2008 $135 2009 $135 2010 $155 2011 $162 2012 $140 2013 $147 2014 $147 2015 $147 2016 $166 2017 $183 2018 $183 2019 $185 2020 $198 2021 $203 2022 $233 2023 $226 2024 $240 2025 $257 Expenses count toward the deductible on the basis of incurred, rather than paid expenses, and are based on Medicare allowed amounts. Non-covered expenses do not count toward the deductible. Even though an individual is not entitled to Part B benefits for the entire calendar year (i.e., insurance coverage begins after the first month of a year or the individual dies before the last month of the year), he or she is still subject to the full deductible for that year. Medical expenses incurred in the portion of the year preceding entitlement to medical insurance are not credited toward the deductible. The date of service generally determines when expenses were incurred, but expenses are allocated to the deductible in the order in which the bills are received. Services not subject to the deductible cannot be used to satisfy the deductible. Pro Rata Amounts Pro Rata Amounts First Month Second Month 2012 $100.20 $39.80 2013 $103.95 $43.05 2014 $114.99 $32.01 2015 $114.99 $32.01 2016 $118.86 $47.14 2017 $125.73 $57.27 2018 $126.88 $56.12 2019 $133.57 $51.43 2020 $140.46 $57.54 2021 $145.31 $57.69 2022 $150.66 $82.34 2023 $154.95 $71.05 2024 $161.71 $78.29 2025 $170.32 $86.68 The Part B deductible is split into pro rata amounts. The purpose of the pro rata amount is to provide beneficiaries who are enrolled in managed care plans the benefit of assuming they have paid their deductible as if they were not enrolled in a managed care plan. The pro rata amount does not apply only to just the first two months of the year but rather for the number of months after first enrollment in a managed care plan that is necessary to cover the Part B deductible. Each year starts the deduction for the pro rata amount over again.