Original Medicare still has no spending cap

Here is a feature of Original Medicare that surprises a lot of people: it has no annual limit on what you can pay out of pocket. Medicare Advantage plans, employer coverage, and marketplace plans all cap your yearly costs, but if you stay in Original Medicare (Part A and Part B) and face a serious illness, the 20 percent you owe under Part B keeps adding up with no ceiling. On June 25, 2026, a group of senators led by Ron Wyden, along with Chuck Schumer and Lisa Blunt Rochester, introduced the Medicare Cost Cap Act, which would create a $5,000 annual out of pocket maximum in Original Medicare and let people spread that amount across the year. The sponsors themselves acknowledge that passing it this year is a long shot, so this is a proposal to understand, not a change to act on. What it usefully spotlights is how people protect themselves today. Because Original Medicare has no cap, most people who choose it add a Medigap (Medicare Supplement) policy, which covers much of that open ended cost sharing for a monthly premium, or they choose a Medicare Advantage plan, which comes with a legal out of pocket maximum built in. Neither path is automatically right; they trade monthly cost against exposure in a bad year, and the best fit depends on your health, your budget, and which doctors you want to keep.