What is MOOP (Maximum Out-of-Pocket)?

"Maximum out of pocket" means the annual maximum dollar amount that a covered person must pay as copayment, deductible, and coinsurance for all covered services and supplies in a calendar year. All amounts paid as copayment, deductible, and coinsurance shall count toward the maximum out of pocket. Once the maximum out of pocket has been reached, the covered person has no further obligation to pay any amounts as copayment, deductible, and coinsurance for covered services and supplies for the remainder of the calendar year. Under ACA, prescription copays and deductibles must be applied to MOOP.

ACA MOOP limits:

2016 - $6,550/Individual $13,100/Family
2017 - $7,150/Individual $14,300/Family

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