50 Wishes for
Medicare’s Future

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Wish #5:
Add a standard Medicare out-of-pocket maximum for beneficiary cost sharing

Original Medicare altogether lacks an out-of-pocket maximum to protect beneficiaries from catastrophic health care costs. The federal government does require Medicare Advantage (MA) plans to include an out-of-pocket maximum in their benefit packages, but these MA maximums are too high—permitting costs up to $6,700 annually. Congress should establish a standard, affordable out-of-pocket maximum in the Medicare program, applicable to both Original Medicare and MA plans.