Adding a Cap on Out-of-Pocket Costs in Medicare

Unlike most health insurance, Medicare does not currently have a cap on beneficiaries’ out-of-pocket (OOP) costs. As a result, millions of people in Medicare can face extremely high OOP expenses if they are sick, unless they have purchased extra private insurance or have other supplemental coverage.

Using this Medicare Calculator, you can design a policy in Medicare to protect beneficiaries from extremely high OOP costs. This calculator displays the effects of implementing the policy, including the number of people who would save on OOP expenses and their average savings by demographic characteristics. The Calculator also estimates the policy's budgetary impact on Medicare as it fills this OOP coverage gap.