What’s in MOOP-v1 (1)
How a MOOP can help manage your money
You must be wondering how exactly can having a maximum out-of-pocket limit save you money? Let’s say you have a Medicare Advantage plan with a $6,700 MOOP. Your normal primary care doctor has a copay of $20. You see this doctor five times a year, so $100 worth of copays is assigned to your MOOP. That year you also have a brief stay in the hospital which involves X-rays [5] and surgery [6], and costs you $6,000. This amount is added to your MOOP.
You leave the hospital feeling better, but as a preventive measure you stick to your therapeutic treatments on an outpatient basis. The total amount you pay towards copays for these treatments comes to $600. You reach your maximum out-of-pocket limit of $6,700!
If you need to go back to the doctor or hospital that same year, the services will be paid for by the insurance company. In other words, once you reach your MOOP you’re off the hook! It is important to use health care providers that take your Medicare advantage plan.