How much will I have to pay out-of-pocket for therapy?

Question

Gary Church · Accepted Answer

Questions come in: How much will I pay out of pocket for therapy? It depends on whether or not you're on original Medicare with a Medicare supplement versus a Medicare Advantage plan. Generally, under a Medicare supplement plan, you're only going to pay your deductible, your Part B deductible, within your plan. And if you're on a Medicare Advantage plan, then it's going to depend on the plan that you have. I would recommend if you're not sure, either reach out to the broker that helped you with your Medicare Advantage plan or reach out to the carrier to find out what your options are. Hopefully, that answers your question.

Daniel Brechin · Answer

It will depend on what program you have 
With Medicare only you will have a 20%copay.
With a supplement depending on what you have could be 0 copay.  Depending on which supplement you have.
With a Medicare Advantage you will have a copay to pay.

Mark Maliwauki · Answer

Depends on your Medicare plan. Most if not all have a copay. If you are talking a rehabilitation center that involves skilled nursing charges which are typically $0 until the 15th to 20th day.

Samantha Jellison · Answer

It will depend on your plan, what the coverage on that plan is and how much your co-payment for the specific therapy is going to be. It will also depend on if you have a medical deductible and if your provider is in or out of network.

Answered by Samantha Jellison on November 23, 2025

Broker Licensed in NC, FL & SC

Answered by Samantha Jellison Medicare Insurance Agent

Maureen Gildea · Answer

This answer varies depends on which plan you choose.    It's best to reach out to a Licensed professional when making a plan choice to view different scenarios and your options.

Michael Brady · Answer

The amount you will pay depends on the plan you have chosen. Your deductiable also my need to be covered . Consult your plans coverages to get a correct amount of what you will need to pay.

Michael Pyers · Answer

Depends which plan you are enrolled in.  Medicare Advantage generally have a co-pay per visit.
Medicare Supplement plans Depending on the plan.  With a plan G then after you meet your part D deductible it should pay for all approved visits.

Priscilla Ramos · Answer

With Original Medicare (Part B) for physical therapy:

You must first meet your Part B deductible for the year.
After that, Medicare usually pays 80% of the Medicare approved amount for medically necessary outpatient therapy, and you pay the remaining 20% coinsurance.

So out of pocket costs can add up depending on how many sessions you need and what your therapist charges, unless you have a Medigap plan or a Medicare Advantage plan that changes your cost‑sharing.

If you want a quick estimate for your specific situation, let me know your plan type!

Valerie Schurman · Answer

Well it will depend on what plan your in   You should be able to call customer service or review your summary of benefits   

thanks

Elea Sherrod · Answer

If you are on Original Medicare and therapy is medically necessary it would be covered under Part B. Generally, you will pay a deductible then 20% coinsurance, the deductible for 2026 is $283. With Original Medicare there is no maximum out of pocket.

Answered by Elea Sherrod on January 26, 2026

Broker Licensed in CA, AL, AR & 35 other states

Answered by Elea Sherrod Medicare Insurance Agent

Meghan Blankenship · Answer

You will generally pay 20% of the Medicare-approved amount for outpatient therapy services after meeting your Part B deductible.

Jennifer Kalbach · Answer

How much you pay out of pocket for therapy depends on the coverage you have.  You can review your summary of benefits for your specific plan to review this.

Carol Conner · Answer

It all depends on which plan you have and what their benefits are. Medicare advantage is different than a supplement so when you’re comparing plans to plan are the same type then they’re gonna be pretty close to about the same amount but it’s always good to have a really review so you can get your options and see what’s gonna fit your needs.

Answered by Carol Conner on November 23, 2025

Broker Licensed in TX

Answered by Carol Conner Medicare Insurance Agent

Adam Ernst · Answer

It will all depend on the carrier you are with if you are on an MA plan. If you have a supplement, the doctor/practice would know exactly how much you would have to pay out of pocket. There are details that would need to be known in order to figure that out. Contact your agent or carrier of your plan to see what the cost would be. If you just have A, B and Part D drug plan, it would be a $257 deductible for the rest of this year, but increases to $283 next year, then your doctor visits would become an 80/20 plan where you pay 20% of what Medicare would pay for.

Answered by Adam Ernst on November 23, 2025

Agent Licensed in NC, SC & TN

Answered by Adam Ernst Medicare Insurance Agent

Julie Thompson · Answer

Out-of pocket expense for physical therapy will depend on which type of plan you have. Some plans will have set copays, some have deductible first then co-insurance and some plans may only be a $0 copay/co-insurance. This is a great time to ask your agent.

Answered by Julie Thompson on December 4, 2025

Agent Licensed in CA, AZ, KY, NV & TN

Answered by Julie Thompson Medicare Insurance Agent

Charles Borg · Answer

It depends on two things. What kind of plan do you have and what kind of therapy do you need? Each plan treats it differently.

Bud Griffin · Answer

It depends on the therapy you are receiving. Check with your provider and ask them what medical code they will be sending to your insurance company when they submit a claim for your treatment.

Kim White · Answer

It all depends on what type of plan you have. For supplements you might have to meet a $283 deductible. For advantage plans your co-pays could be $10-$40 per visit depending on the plan.

Tetonya Lewis Charles · Answer

How much you will have to pay out-of-pocket for therapy will vary by carriers. Whether HUMANA, CIGNA, United, AETNA, or other, in each plan the cost will vary. It's important to check with the carrier you're choosing for your out-of-pocket cost for therapy.

Answered by Tetonya Lewis Charles on November 23, 2025

Broker Licensed in NC, FL, MD, MI, SC & TX

Answered by Tetonya Lewis Charles Medicare Insurance Agent

Marisa Padilla · Answer

It depends on what type of Medicare plan you choose. 

If you choose to have Original Medicare + Medicare Supplement Plan G for example, AND your therapist accepts and bills Original Medicare, you should not have to pay anything out-of-pocket for your visits if you have already met your Part B Medical Deductible of $283. 

If you choose to have a Medicare Advantage Part C Plan, and you either have no deductible (common) or you have already met your plan's deductible, then your per-visit copay for therapy can range from maybe $15-$60 per session (these are just estimates and depend greatly on the actual plans offered in your zip code).

How much will I have to pay out-of-pocket for therapy?

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How much will I have to pay out-of-pocket for therapy?

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