US · guidance
CMS Pub. 100-16, ch. 8, § 60
General Rules for Calculating MA Plan Payments
See Chapter 7 of the manual (forthcoming) for information on the bidding methodology. In
short, under the bidding methodology each plan’s bid for coverage of Part A and Part B
benefits (i.e., its revenue requirements for offering original Medicare benefits) is compared
to the plan benchmark (i.e., the upper limit of CMS’ payment, developed from the county
capitation rates in the local plan’s service area or from the MA regional benchmarks for
regional plans). The purpose of the bid-benchmark comparison is to determine whether the
plan must offer supplemental benefits or must charge a basic beneficiary premium for A/B
benefits.
History
(Rev. 89; Issued: 11-02-07; Effective/Implementation: 11-02-07)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
374679a2889e1a973f450d2e56bf471ce51f0b2617ff3a319821a6072329fed0
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