The Maximum Out-of-Pocket (MOOP) Limit for a Medicare Advantage plan caps how much you will spend on co-payments and co-insurance for covered or eligible Medicare Part A (hospitalization) and Part B (out-patient) medical services (and may include additional or supplemental benefits). Your Maximum Out-of-Pocket for Medicare Part D expenses is separate -- this is known as TrOOP or Total Out-of-Pocket costs.

Each Medicare Advantage plan sets its plan's MOOP.  The maximum out-of-pocket limit can range from $0 to $6,700.  Typically, Medicare Advantage plans with a MOOP of $0 are Special Needs Plans (SNPs).  The table below illustrates the most frequently occurring MOOP limits across all types of Medicare Advantage plans.

Medicare Advantage plans may set their MOOP as any amount within the ranges shown in the CMS table below. This table shows that MOOP limits may be lower than the CMS-established maximum amounts and what MOOP amounts qualify as mandatory and voluntary MOOP limits.

As can be seen in the table above, out-of-network cost-sharing expenses may fall into a higher MOOP (for example, see Regional PPO above with a higher "combined" MOOP limit) or your out-of-network cost-sharing may not count toward your MOOP limit, as with the HMO POS plan type.