What's Your Medicare Advantage Maximum Out-of-Pocket (MOOP) ?

 

The Medicare Advantage Maximum Out-of-Pocket (MOOP) is an annual limit on the amount of money you have to pay for covered services in a Medicare Advantage plan. Once you reach your MOOP, you will not have to pay any more out-of-pocket costs for covered services for the rest of the year.

The Medicare Advantage MOOP for 2023 is $8,300 for in-network services and $12,450 for in-network and out-of-network services combined. However, plans may set lower limits.

The out-of-pocket costs that count towards your MOOP include:

• Deductibles
• Coinsurance
• Copayments
• Some prescription drug costs

Part D cost-sharing does not count towards your plan's MOOP.

If you are enrolled in a Medicare Advantage plan with a high MOOP, you may want to consider a plan with a lower MOOP or a plan that offers a prescription drug benefit. You can compare plans and their MOOPs using the Medicare Plan Finder tool on the Medicare website.

Here are some additional things to keep in mind about the Medicare Advantage MOOP:

• The MOOP is per person. This means that if you are married and both you and your spouse are enrolled in the same plan, you will each have your own MOOP.
• The MOOP resets at the beginning of each year. This means that if you reach your MOOP in January, you will start over in February.
• The MOOP does not apply to all services. For example, some preventive services are not subject to the MOOP.

To take a look at you MOOP fill out the Permission to Contact form and a licensed agent will be in contact