Ashford Insurance

How Do Medicare Copays and Deductibles Work?

Medicare Made Easy

Now, more than ever, it is vitally important that you understand your healthcare options. Choosing the right plan is the single most important decision you’ll make for your future health. As a licensed Medicare supplement insurance agent in the state of Texas, we work with many TX health insurance carriers and will be your advocate in dealing with them. Our broker and consultant services are offered at no cost to you.

Medicare is a federal health insurance program that pays most of the health care costs for people who are 65 or older.  It will also pay for health care for some people under age 65 who have disabilities.

How Do Medicare Copays and Deductibles Work?

Copays and coinsurance

A copay is a fixed amount of money you pay for a certain service. Your health insurance plan pays the rest of the cost. Coinsurance refers to percentages.

Most Medicare Advantage plans use copays for most services. You pay 20 percent coinsurance for most services with Original Medicare. 


A deductible is the amount of money you pay for health care services before your plan kicks in and starts paying. For most services, you’ll pay full cost until you reach the deductible. After you reach your deductible, you’ll still have to pay any copays or coinsurance. Some services will be covered by your plan before you reach the deductible.

Cover your Medicare out-of-pocket costs

There is one way that many Medicare enrollees get help covering their Medicare out-of-pocket costs.

Medigap insurance plans are a form of private health insurance that helps supplement your Original Medicare coverage. You pay a premium to a private insurance company for enrollment in a Medigap plan, and the Medigap insurance helps pay for certain Medicare out-of-pocket costs including certain deductibles, copayments, and coinsurance.

Whether an “all-in-one” Medicare Advantage plan or a standalone Part D plan suits you, Ashford Insurance can help. Get a quote for prescription drug plans online now at no cost to you. Or, let one of our licensed agents review your options and find the best drug insurance plan for your unique needs. Just give us a call today at 817-952-3153.

At Ashford Insurance, in Hurst, TX, we connect our clients with the best insurance companies in the industry. As an independent insurance agency, our options are unlimited when it comes to your coverage. We serve individuals and businesses in D/FW and its surrounding areas in Texas.


Next, learn: Medicare Assignment