What is the Medicare Advantage combined in-network and out-of-network MOOP? | Patriot Plans
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HomeMedicareWhat is the Medicare Advantage combined in-network and out-of-network MOOP?
Medicare Advantage

What is the Medicare Advantage combined in-network and out-of-network MOOP?

Medicare Advantage PPO plans have two MOOP limits: an in-network MOOP and a combined in-network and out-of-network MOOP. The combined MOOP in 2026 is $14,000. After reaching the combined MOOP, the plan pays 100% of covered in-network and out-of-network services for the rest of the year.

Key Points

  • PPO plans have two MOOP limits: in-network and combined
  • 2026 combined MOOP limit: $14,000
  • After combined MOOP: plan pays 100% of covered in-network and out-of-network services
  • In-network MOOP: $9,350 (2026)
  • An independent agent can help you understand MOOP limits for PPO plans
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