Published: July 2018

3M seniors could lose critical benefits if Benchmark Cap remains in Medicare Advantage

Three million American seniors are at risk of being denied critically important benefits like care coordination, vision, dental, hearing, and wellness programs if Congress allows the benchmark cap to stay in place. In a letter to Congress, coalition advocates supported the bipartisan Improving Seniors Access to Quality Benefits Act (HR 4952), which aims to lift the benchmark cap, thus giving beneficiaries higher-quality care.

Consumer Action joined the Better Medicare Alliance in urging Congress to support the Improving Seniors Access to Quality Benefits Act (HR 4952). Medicare Advantage is an important source of health coverage for more than 20 million seniors and individuals with disabilities, and the incentives for driving integrated and coordinated high-quality care for beneficiaries is one of the distinguishing hallmarks of Medicare Advantage compared to Traditional Fee-for-Service (FFS) Medicare.

The Benchmark Cap inequitably penalizes nearly 5.8 million Medicare Advantage enrollees by denying them access to enhanced benefits available to other beneficiaries in high quality Medicare Advantage plans, simply because of geography. The HR 4952 aims to remedy the problem of the so-called “Benchmark Cap” in Medicare Advantage.

Lead Organization

Better Medicare Alliance

Other Organizations

AMGA | American Telemedicine Association | Association for Behavioral Health and Wellness | Better Medicare Alliance | Consumer Action | Council for Affordable Health Coverage | Healthcare Leadership Council | Meals on Wheels America | National Association of Nutrition and Aging Services Programs (NANASP) | National Coalition on Health Care | National Hispanic Council on Aging | National Minority Quality Forum | SNP Alliance

More Information

To read the letter in full, please click here.

For more information, please visit Better Medicare Alliance.

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