The Medicare Advantage benchmark is the maximum amount CMS will pay a Medicare Advantage plan for each enrollee. The benchmark is based on the average Medicare spending in the county. Plans that bid below the benchmark receive a rebate, which they can use to offer additional benefits or reduce premiums.
Key Points
- Benchmark: maximum amount CMS pays per enrollee
- Based on average Medicare spending in the county
- Plans bidding below benchmark: receive a rebate
- Rebate used to offer additional benefits or reduce premiums
- Higher benchmark counties: more plan competition and better benefits