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

Mar, 19 2025 — TrOOP or your true out-of-pocket spending is the amount you - or others on your behalf - spend toward your Medicare Part D plan's formulary Part D drugs. For example, if you purchase a $100 formulary . . .

Oct, 28 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

Mar, 19 2025 — 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.

Mar, 09 2025 — 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 . . .

Apr, 11 2025 — No, TrOOP does not count toward your Medicare Advantage plan's MOOP limit.  TrOOP and MOOP are two different measures of out-of-pocket (OOP) costs - and TrOOP and MOOP are not related, aside from . . .

Apr, 17 2025 — After meeting your Medicare Part D prescription drug plan's out-of-pocket spending limit (TrOOP), you will exit your Medicare plan's Initial Coverage phase and enter the last phase of Medicare Part D . . .

Apr, 10 2025 — RxMOOP is the maximum out-of-pocket spending limit for Medicare Part D prescription drugs. In 2025, RxMOOP is $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 . . .

Oct, 28 2024 — Yes. If you are enrolled in a Medicare drug plan with Enhanced Alternative (EA) benefits, you will get credit toward your $2,000 spending limit for the "greater of" your EA plan spending - or the spending you would have if you were enrolled in a Defined Standard Part D

Oct, 28 2024 — No. The annual $2,000 Medicare Part D maximum out-of-pocket spending limit (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.

Apr, 17 2025 — After meeting your Medicare Part D prescription drug plan's out-of-pocket spending limit (TrOOP), you will exit your Medicare plan's Initial Coverage phase and enter the last phase of Medicare Part D . . .

Apr, 11 2025 — No, TrOOP does not count toward your Medicare Advantage plan's MOOP limit.  TrOOP and MOOP are two different measures of out-of-pocket (OOP) costs - and TrOOP and MOOP are not related, aside from . . .

Apr, 10 2025 — RxMOOP is the maximum out-of-pocket spending limit for Medicare Part D prescription drugs. In 2025, RxMOOP is $2,000 and can change each year thereafter along with other Medicare Part D plan parameters.

Mar, 19 2025 — 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.

Mar, 19 2025 — TrOOP or your true out-of-pocket spending is the amount you - or others on your behalf - spend toward your Medicare Part D plan's formulary Part D drugs. For example, if you purchase a $100 formulary . . .

Mar, 09 2025 — 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.

Oct, 28 2024 — No. The annual $2,000 Medicare Part D maximum out-of-pocket spending limit (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, 28 2024 — Yes. If you are enrolled in a Medicare drug plan with Enhanced Alternative (EA) benefits, you will get credit toward your $2,000 spending limit for the "greater of" your EA plan spending - or the spending you would have if you were enrolled in a Defined Standard Part D

Oct, 28 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

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 . . .

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 . . .