What is Medicare MOOP?
In 2025, Medicare’s maximum out-of-pocket costs vary depending on the type of coverage.
Original Medicare (Parts A and B):
- There is no annual out-of-pocket maximum for Original Medicare. This means there’s no cap on your potential expenses for covered services.
National Council On Aging
Medicare Advantage (Part C):
- The maximum out-of-pocket (MOOP) limit for in-network services under Medicare Advantage plans is $9,350 in 2025. However, individual plans may set lower limits.
medicareresources.org
Medicare Part D (Prescription Drug Coverage):
- Starting in 2025, annual out-of-pocket costs for prescription drugs under Part D plans will be capped at $2,000. Once you reach this limit, you won’t have to pay further copayments or coinsurance for covered drugs for the rest of the year.
Medicare.gov
Medicare Supplement (Medigap) Plans:
- For Medigap Plan K, the out-of-pocket maximum in 2025 is $7,220. For Plan L, it’s $3,610. After reaching these limits, the plan covers 100% of approved services for the remainder of the year.
National Council On Aging
It’s important to note that these maximum out-of-pocket costs apply to covered services. Non-covered services or services received from out-of-network providers may result in additional costs. Additionally, while Original Medicare doesn’t have an out-of-pocket maximum, enrolling in a Medigap policy can help cover some of these expenses.
For more detailed information, you can refer to the official Medicare & You 2025 Handbook.