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Maximum Out-of-Pocket Limits in Dual-Eligible Special Needs Plans

JAMA Health Forum 10.1001/jamahealthforum.2026.2699

August 14, 2026 at 11:00 AM EDT

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This cross-sectional study assesses changes maximum out-of-pocket costs in dual-eligible Medicare and Medicaid beneficiaries from 2017 to 2026 following the 2023 updated guidance for calculating maximum out-of-pocket spending.

Corresponding Author: Katherine M. Ianni, PhD, Division of Health Policy and Economics, Department of Population Health Sciences, Weill Cornell Medicine, 575 Lexington Ave, 6th Floor, New York, NY 10022 (kai4003@med.cornell.edu).

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