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How will the out-of-pocket-maximum work if my spouse and I both enroll in a Medicare Advantage Plan?

If you and your spouse are Medicare eligible and enroll in one of the new Medicare Advantage plans, you will each have a separate annual out-of-pocket maximum. This means that amounts you pay out of pocket for your care will only count toward your annual out-of-pocket maximum and not your spouse’s. Similarly, amounts you pay out-of-pocket for your spouse’s care will only count toward your spouse’s annual of-of-pocket maximum. CMS does not allow out-of-pocket maximums to coordinate for a family in Medicare Advantage plans.

Reviewed 2024-04-25