What’s a Medicare Advantage MOOP?

What to Know about MOOP?

Your maximum out-of-pocket limit (also known as a MOOP) is a very important aspect of your plan, especially if you have large annual medical bills from doctor visits and hospital stays. Are wondering how it works? Stay with me to find out! The MOOP is an insurance concept not understood by many people, so let’s explain it.

When it comes to your Medicare coverage, your plan is going to pay for a lot, whether you have original Medicare or Medicare advantage. But, just like any insurance, there are some particular out-of-pocket costs that you’ll be expected to pay.

If you have a year where you have to use your plan frequently, it’s okay to worry that your out-of-pocket (OOP) costs may grow rapidly. Fortunately, Medicare has protective measures to make sure that your OOP costs don’t get out of hand! They’re in the form of a little group in your plan known as MOOP. You can notice examples of MOOPs in your area, as well as directly compare those and other plan details, using the Medicareful Plan Finder.

Maximum out-of-pocket: The highest money you’ll pay for insured health care in a calendar year, aside from any monthly premium. When you reach your MOOP, your insurance company pays for 100% of covered services.

The United States government sets the standard Medicare Advantage maximum out-of-pocket limit every year. In 2019, this amount was about $6,700, which is a common MOOP limit. However, you should understand that some insurance companies apply lower MOOP limits, while some plans may have higher limits.