Hi, I’m Gerie Brinkerhoff with Journey Insurance Solutions, and today I want to talk about something that can make a big difference in how protected — and how prepared — you feel with your Medicare coverage: something called MOOP.

Let’s break it down in plain English.

What is MOOP?

MOOP stands for Maximum Out-of-Pocket. And it’s exactly what it sounds like — the maximum amount you’ll have to pay out of your own pocket for covered medical expenses in a calendar year.

Think of it as a built-in safety net.

With Original Medicare (Parts A & B), there’s no out-of-pocket maximum. That means if you have a surgery, chronic illness, or need extensive treatments, the 20% coinsurance could keep adding up with no end in sight.

But with a Medicare Advantage plan (Part C), you get something that Original Medicare doesn’t offer:

A hard limit on your out-of-pocket costs for the year.

Once you reach that cap — whether it’s through copays, coinsurance, or other approved costs — your plan pays 100% of covered medical expenses for the rest of the year.

Why That Matters

Here’s what that might look like in 2025:

• Some Advantage plans have MOOP limits as low as $4,500
• Others may go up to around $8,300
• Either way, you have a known ceiling on your medical costs — and that gives you peace of mind

This “stop-loss” feature is especially important if:

• You live on a fixed income
• You want predictable costs
• You’re concerned about big health events or hospital bills

Bottom Line

If you’re looking for coverage that gives you more cost protection, a Medicare Advantage plan with MOOP could be a great option. It won’t eliminate your healthcare expenses — but it does put a clear limit on how much you’ll have to pay in a worst-case scenario.

And that kind of protection is not just practical. It’s powerful.

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Need help figuring out if a Medicare Advantage plan is right for you?

I’d love to walk through your options in a free, no-pressure Medicare review.