Medicare Advantage plans have a maximum out-of-pocket (MOOP) limit that caps your annual out-of-pocket costs for covered services. In 2026, the MOOP limit for in-network services is $9,350. After reaching the MOOP, the plan pays 100% of covered services for the rest of the year.
Key Points
- MOOP: annual cap on out-of-pocket costs for covered services
- 2026 MOOP limit: $9,350 for in-network services
- After MOOP: plan pays 100% of covered services
- MOOP does not apply to premiums or out-of-network services (for PPO plans)
- Original Medicare has no MOOP — Medicare Supplement provides this protection