What do deductible, copayment, and coinsurance mean?
A deductible is what you pay before Medicare starts to pay. A copayment is a set dollar amount, like a flat fee. Coinsurance is a percentage of the cost, like 20%.
The amounts
2026
2027
Part B yearly deductible
$283Official
$292Estimate
An estimate is a projection from the source it cites, not an official amount.
What matters most
Deductible: you pay first
A deductible is the amount you pay yourself before Medicare starts to pay. In 2026, the Part B deductible is $283.
Copayment: a set amount
A copayment is a fixed dollar amount you pay, like a flat fee at the pharmacy.
Coinsurance: a percentage
Coinsurance is a percentage of the cost you pay. You usually pay 20% of the cost after your deductible.
Want the detail? How it works, a worked example and common mix-ups are in .
Words on this page
Deductible
what you pay before Medicare starts to pay
Copayment (copay)
a fixed dollar amount you pay, like a flat fee
Coinsurance
a percentage of the cost you pay, like 20%
Premium
the amount you pay each month to have the coverage
Who can answer for your situation
If a bill or plan document uses these words and you're unsure, 1-800-MEDICARE (1-800-633-4227) can walk you through it.
It explains whether there's a yearly limit on all these amounts you pay.
How the three fit together
Usually you pay the deductible first. That's the amount you cover yourself before Medicare starts to pay.
After that, your share is usually a copayment (a set amount) or coinsurance (a percentage). You'll usually pay 20% of the cost for each Medicare-covered service or item.
An example
Say you've paid the $283 Part B deductible for 2026. For a covered $200 service after that, you'd usually pay 20% of the cost: $40. A plan that uses a copayment might charge a set amount instead.
Common mix-ups
These are the pairs people most often mix up.
Copayment vs. coinsurance
A copayment is a fixed amount, like a flat fee. Coinsurance is a percentage of the cost, like 20%.
Deductible vs. premium
A deductible is what you pay for care before Medicare pays. Don't mix it up with the premium — the amount you pay each month, like $202.90 a month for Part B in 2026.
7 What the source says · Table V.E2, SMI Cost-Sharing and Premium Amounts (page 207): the 2027 row, Part B standard monthly premium, then Part B annual deductible Estimate
Intermediate estimates: 2027 209.50 292
Checked September 27, 2026
Something look wrong?
If something here doesn’t match what you’ve been told, please check with 1-800-MEDICARE, and let us know through our Contact page.
General education, not individualized advice. For your own situation, you can call 1-800-MEDICARE or your State Health Insurance Assistance Program (SHIP).
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