Understanding your Traditional Medicare deductible reset

As the calendar flips to 2025 and your annual Traditional Medicare (Part B) deductible reset approaches, Cadence is here to help you go into the new year confident about your healthcare budget. Even if you see no cost for Cadence or other healthcare services today, that could change when deductibles reset.

Let’s break it down together. In this blog post, we’ll explore what the deductible reset means, how it impacts you, and how it may impact your healthcare costs at the start of the year.

What is a deductible, and why does it matter?

‍Think of your deductible as the amount you have to pay out-of-pocket for healthcare services—like doctor visits, lab tests, or remote patient care—before Traditional Medicare starts to share the costs with you.

In 2025, the Traditional Medicare deductible will be $257 (if you have Medicare Advantage, also known as Part C, your deductible may be different). Once you’ve spent this amount, Traditional Medicare coverage kicks in and typically covers 80% of outpatient service costs, leaving you responsible for the remaining 20% (i.e., coinsurance) unless you have additional coverage.

How does the deductible reset affect me?‍

When the deductible resets each January, you’ll temporarily cover the 80% of outpatient service costs that your insurance usually pays until you’ve met the $257 deductible. While you’re paying to meet that deductible, 20% of your total payment will still be used to cover your coinsurance for each service. These costs will show up in your first few medical bills of the year and could be from your primary care provider, specialists you see, or remote patient care programs.

Here’s an example of what your costs might look like for your first few medical bills of the year with Traditional Medicare(Part B without a supplemental plan):

After your deductible is met, Medicare will start paying its portion (typically 80%), and significantly reduce your out-of-pocket expenses. Patients with Medicare Advantage or Medicare Replacement plans may also have a deductible that applies. We encourage you to reach out to your insurance provider to understand your specific coverage and costs.

These early costs might be an adjustment, but proactive care, like remote patient care, can help you manage your health and avoid unexpected complications later in the year. Learn more about the long-term benefits of remote patient care in our blog, Remote patient care: a cost-effective approach to better health.

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Understanding your out-of-pocket costs and coverage for remote patient care‍

To understand your exact out-of-pocket costs at the start of the year, reach out to your insurance provider and ask them whether you have a deductible, copay, or coinsurance and how that will impact your out-of-pocket costs for healthcare services.

Remote patient care is a covered benefit under Medicare and Medicare Advantage. Monthly costs vary based on whether a patient has met their deductible, how patients use the program, and their types of insurance coverage. The services Cadence provides are delivered under the supervision of your provider, and your doctor bills your insurance directly for remote monitoring services.  

If you have questions about how much remote patient care will cost as your Medicare deductible resets, we recommend contacting your insurance company directly. You can provide the billing codes below to get an estimate of your out-of-pocket expenses: 

• Device Setup: 99453
• Data Collection: 99454
• First 20 minutes of provider time: 99457
• Each additional 20 minutes of provider time: 99458

If you are enrolled in Cadence and have questions about your bill you can email us at support@cadencerpm.zendesk.com.

Key takeaways

The Medicare deductible resets every year, and it’s important to keep this in mind when planning for your healthcare costs. Knowing how your plan covers outpatient care can help you prepare your healthcare budget for 2025.

For more on how remote patient care can help you manage your health and avoid unexpected costs, check out our blog, Remote patient care: a cost-effective approach to better health. 

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Any information provided on this website is intended for general educational purposes and is not intended to be medical advice. You should always consult with your own medical provider about your health and medical questions and never rely on this or any other website alone to make medical decisions. Do not delay seeking medical advice or disregard any medical advice you have received from your provider because of anything you read on the website. Please contact your insurance provider with specific questions about billing or insurance.