TrOOP (Total out-of-pocket costs) is your out-of-pocket spending for Medicare Part D prescription drug purchases, whether provided by a Medicare Advantage plan that includes prescription drug coverage (MAPD) or a stand-alone Medicare Part D plan (PDP) -- TrOOP does not include your drug plan premiums paid.
The TrOOP limit (also known as the RxMOOP) defines the maximum you will spend on formulary drug purchases for the year. Once your TrOOP goes beyond the RxMOOP, you exit the Initial Coverage phase and enter the Catastrophic Coverage portion of your Medicare Part D plan where pay nothing for your formulary drug purchases for the remainder of the year.
Each year, the Centers for Medicare and Medicaid Services (CMS) establishes the annual RxMOOP (TrOOP limit) The RxMOOP is $2,000 in 2025 and $2,100 in 2026. You can see how TrOOP limits have changed over the years
on this site MOOP (Maximum out-of-pocket costs) is your actual out-of-pocket spending for Medicare Part A and Medicare Part B covered services. MOOP does not include your Medicare plan premiums.
The MOOP limit is a Medicare Advantage plan's OOP spending limit for Medicare Part A and Medicare Part B covered services. When you reach your plan's MOOP, you should not have more Medicare Part A and Medicare Part B in-network expenses for the remainder of the year.
Look for language in your Medicare Advantage Summary of Benefits that might read something like: "Your yearly limit(s) in this plan: $6,700 for services you receive from in-network providers. If you reach the limit on out-of-pocket costs [MOOP], you keep getting covered hospital and medical services and we will pay the full cost for the rest of the year."
However, depending on your Medicare Advantage plan, out-of-network coverage might be excluded from your MOOP. Please look for language in your Medicare Advantage plans (MA or MAPD) Summary of Benefits that reads like: "Your yearly limit(s) in this plan: $4,000 for services you receive from in-network providers. If you reach the limit on out-of-pocket costs [MOOP], you keep getting covered hospital [Medicare Part A] and medical [Medicare Part B] services and we will pay the full cost for the rest of the year. Please note that you will still need to pay your monthly premiums and cost-sharing for your Part D prescription drugs."
Medicare Advantage plans can have varying MOOP limits and each year CMS establishes a limit on MOOP. In 2025, MOOP is limited to $9,350. You can see how MOOP varies between 2022/2023/2024/2025 Medicare Advantage plans on this site.
We also have a section of FAQs on the TrOOP / MOOP topic
on this site
on this site
Also see FAQ:
What is the Medicare Part D RxMOOP?