Frequently Asked Questions about Out-of-Pocket: TrOOP, RxMOOP, and MOOP

Aug, 07 2024 — TrOOP or your total out-of-pocket spending is the total amount you (or others on your behalf) have spent during the year on your formulary drugs.  The TrOOP threshold is the maximum spending befo . . .

Jun, 06 2024 — Your Medicare Advantage plan’s Maximum Out-of-Pocket Limit (MOOP) is the total amount you will spend this year on in-network copayments and coinsurance for covered or eligible Medicare Part A and Medicare Part B medical services - but, some healthcare coverage may be excluded

Apr, 23 2024 — Yes. If you use a Special Enrollment Period (SEP) to change Medicare drug plans during the year, you will find that both the total retail value of your drug purchases and the total value of your out-of-pocket spending (TrOOP) transfer to your new Part D plan.

Apr, 23 2024 — Maybe. If you are able to change or transfer to another Medicare Advantage plan offered by the same company during the plan year, you may be able to transfer the amount that you have spent for your Medicare Part A and Part B coverage toward your new plan's MOOP limit.

Aug, 20 2024 — You do not pay anything more for your Medicare Part A and Medicare Part B covered services for the remainder of the year. Your Medicare Advantage plan’s MOOP or Maximum Out-of-Pocket limit . . .

Jul, 13 2024 — After meeting your Medicare Part D prescription drug plan's out-of-pocket spending limit (TrOOP), you will exit your Medicare plan's Coverage Gap (Donut Hole) and enter the last phase of Medicare Part . . .

Apr, 20 2024 — No.  TrOOP and MOOP are two different measures of out-of-pocket (OOP) costs - and TrOOP and MOOP are not related, aside from both defining OOP costs - and your TrOOP does not count toward your MO . . .

Aug, 12 2024 — RxMOOP is the maximum out-of-pocket spending limit for Medicare Part D prescription drugs. In 2024, RxMOOP will be the TrOOP threshold ($8,000). Starting in 2025, RxMOOP will be $2,000 and can change each year thereafter along with other Medicare Part D plan parameters.

Apr, 23 2024 — Yes.  Medicare Part D prescription drug plans (PDPs and MAPDs) are required to keep track of each person’s prescription drug spending or TrOOP costs - so your out-of-pocket spending and . . .

Nov, 04 2018 — No.  Your out of pocket costs or TrOOP does not determine when you enter the Coverage Gap.  Instead, TrOOP determines when you exit the Coverage Gap and enter the Catastrophic Coverage phase . . .

Oct, 01 2024 — No. The annual $2,000 Medicare Part D maximum out-of-pocket spending limit (TrOOP or RxMOOP) does not include non-Part D drugs or drugs excluded from the Part D program - even when the drugs are on the Medicare drug plan's formulary as Bonus or Supplemental drugs.

Oct, 01 2024 — No. The annual $2,000 Medicare Part D maximum out-of-pocket spending limit (TrOOP or RxMOOP) does not include non-Part D drugs or drugs excluded from the Part D program - even when the drugs are on the Medicare drug plan's formulary as Bonus or Supplemental drugs.

Aug, 20 2024 — You do not pay anything more for your Medicare Part A and Medicare Part B covered services for the remainder of the year. Your Medicare Advantage plan’s MOOP or Maximum Out-of-Pocket limit . . .

Aug, 12 2024 — RxMOOP is the maximum out-of-pocket spending limit for Medicare Part D prescription drugs. In 2024, RxMOOP will be the TrOOP threshold ($8,000). Starting in 2025, RxMOOP will be $2,000 and can change each year thereafter along with other Medicare Part D plan parameters.

Aug, 07 2024 — TrOOP or your total out-of-pocket spending is the total amount you (or others on your behalf) have spent during the year on your formulary drugs.  The TrOOP threshold is the maximum spending befo . . .

Jul, 13 2024 — After meeting your Medicare Part D prescription drug plan's out-of-pocket spending limit (TrOOP), you will exit your Medicare plan's Coverage Gap (Donut Hole) and enter the last phase of Medicare Part . . .

Jun, 06 2024 — Your Medicare Advantage plan’s Maximum Out-of-Pocket Limit (MOOP) is the total amount you will spend this year on in-network copayments and coinsurance for covered or eligible Medicare Part A and Medicare Part B medical services - but, some healthcare coverage may be excluded

Apr, 23 2024 — Yes. If you use a Special Enrollment Period (SEP) to change Medicare drug plans during the year, you will find that both the total retail value of your drug purchases and the total value of your out-of-pocket spending (TrOOP) transfer to your new Part D plan.

Apr, 23 2024 — Yes.  Medicare Part D prescription drug plans (PDPs and MAPDs) are required to keep track of each person’s prescription drug spending or TrOOP costs - so your out-of-pocket spending and . . .

Apr, 23 2024 — Maybe. If you are able to change or transfer to another Medicare Advantage plan offered by the same company during the plan year, you may be able to transfer the amount that you have spent for your Medicare Part A and Part B coverage toward your new plan's MOOP limit.

Apr, 20 2024 — No.  TrOOP and MOOP are two different measures of out-of-pocket (OOP) costs - and TrOOP and MOOP are not related, aside from both defining OOP costs - and your TrOOP does not count toward your MO . . .

Nov, 04 2018 — No.  Your out of pocket costs or TrOOP does not determine when you enter the Coverage Gap.  Instead, TrOOP determines when you exit the Coverage Gap and enter the Catastrophic Coverage phase . . .