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How Out-of-Pocket Spending Caps in Traditional Medicare Could Affect Beneficiary and Program Spending

08.2026 / By Urban Institute

Traditional Medicare has no annual limit on out-of-pocket costs for Parts A and B, but the Medicare Cost Cap Act would cap them at $5,000 a year. This blog discusses new estimates finding that a $5,000 cap would lower cost-sharing for more than 4 million enrollees while adding $36.2 billion to Medicare spending in one year.

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