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Advising the Congress on Medicare issues
MedPAC > Recommendations > Reforming Medicare’s benefit design

Reforming Medicare’s benefit design

June 15, 2012

The Congress should direct the Secretary to develop and implement a fee-for-service benefit design that would replace the current design and would include:

  • an out-of-pocket maximum;
  • deductible(s) for Part A and Part B services;
  • replacing coinsurance with copayments that may vary by type of service and provider;
  • secretarial authority to alter or eliminate cost sharing based on the evidence of the value of services, including cost sharing after the beneficiary has reached the out-of-pocket maximum;
  • no change in beneficiaries’ aggregate cost-sharing liability; and
  • an additional charge on supplemental insurance.

Topics: Beneficiaries and coverage and Delivery system reforms.