PACE, Special Needs Plans, Part B–only plans, employer-sponsored plans, and plans under sanction are excluded.
Each year, the Centers for Medicare and Medicaid Services (CMS) sets a Medicare Advantage (MA) maximum out-of-pocket (MOOP) limit to reduce beneficiary financial risk. Beneficiary cost-sharing for Part A and Part B services is waived once a beneficiary reaches the MOOP amount. The CMS-allowed MOOP limit provides a ceiling for MA plans’ MOOP limits, and plans may choose to set a lower limit. CMS has set the in-network, maximum out-of-pocket limit at $7,550 per year, up from the $6,700 limit set for 2010 to 2020.
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Average MA out-of-pocket maximum in the U.S. 2022, by plan type
For 2022, the maximum out-of-pocket (MOOP) amount a Medicare Advantage beneficiary will pay is U.S. dollars. This is nearly a third less than the MOOP limit set by the Centers for Medicare & Medicaid Services that year, which was U.S. dollars. MOOP is the most a beneficiary must pay out-of-pocket (including deductibles, co-pays and co-insurance) for covered services in a plan year. This statistic shows the average Medicare Advantage maximum out-of-pocket amount for 2022, by plan type (in U.S. dollars).
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Commonwealth Fund. (August 22, 2022). Average Medicare Advantage (MA) maximum out-of-pocket (MOOP) amount in the U.S. for 2022, by type of plan (in U.S. dollars) [Graph]. In ÌÇÐÄÆƽâ°æ. Retrieved July 20, 2026, from /statistics/1265646/average-ma-out-of-pocket-maximum-by-plan-type-us/
Commonwealth Fund. "Average Medicare Advantage (MA) maximum out-of-pocket (MOOP) amount in the U.S. for 2022, by type of plan (in U.S. dollars)." Chart. August 22, 2022. ÌÇÐÄÆƽâ°æ. Accessed July 20, 2026. /statistics/1265646/average-ma-out-of-pocket-maximum-by-plan-type-us/
Commonwealth Fund. (2022). Average Medicare Advantage (MA) maximum out-of-pocket (MOOP) amount in the U.S. for 2022, by type of plan (in U.S. dollars). ÌÇÐÄÆƽâ°æ. ÌÇÐÄÆƽâ°æ Inc.. Accessed: July 20, 2026. /statistics/1265646/average-ma-out-of-pocket-maximum-by-plan-type-us/
Commonwealth Fund. "Average Medicare Advantage (Ma) Maximum Out-of-pocket (Moop) Amount in The U.S. for 2022, by Type of Plan (in U.S. Dollars)." ÌÇÐÄÆƽâ°æ, ÌÇÐÄÆƽâ°æ Inc., 22 Aug 2022, /statistics/1265646/average-ma-out-of-pocket-maximum-by-plan-type-us/
Commonwealth Fund, Average Medicare Advantage (MA) maximum out-of-pocket (MOOP) amount in the U.S. for 2022, by type of plan (in U.S. dollars) ÌÇÐÄÆƽâ°æ, /statistics/1265646/average-ma-out-of-pocket-maximum-by-plan-type-us/ (last visited July 20, 2026)
Average Medicare Advantage (MA) maximum out-of-pocket (MOOP) amount in the U.S. for 2022, by type of plan (in U.S. dollars) [Graph], Commonwealth Fund, August 22, 2022. [Online]. Available: /statistics/1265646/average-ma-out-of-pocket-maximum-by-plan-type-us/
