MOOP
Medical abbreviation · Health Insurance
| Stands for | Maximum out-of-pocket |
|---|---|
| Categories | Medical |
MOOP stands for Maximum out-of-pocket, a health insurance abbreviation.
Annual cap on what a member pays for covered services, a term used especially for Medicare Advantage plans, which must limit enrollee cost sharing for Medicare-covered services. CMS sets the highest MOOP a plan may use each year, and many plans choose lower limits.
Example: My Medicare Advantage plan's MOOP is $5,900 in network.
Usage notes
Original Medicare has no out-of-pocket maximum, one reason many beneficiaries buy Medigap or join Medicare Advantage. PPO-style Medicare Advantage plans have an in-network MOOP and a higher combined in- and out-of-network MOOP. Part D drug costs are capped separately.
Related abbreviations
More health insurance abbreviations
- MAGI – Modified adjusted gross income
- MAPD – Medicare Advantage Prescription Drug plan
- MCO – Managed care organization
- MEC – Minimum essential coverage
- MIPS – Merit-based Incentive Payment System
- MLR – Medical loss ratio
- MPFS – Medicare Physician Fee Schedule
- MS-DRG – Medicare Severity Diagnosis-Related Group
- MSP – Medicare Savings Program
- NCCI – National Correct Coding Initiative
- NCD – National coverage determination
- NCQA – National Committee for Quality Assurance
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This entry is for general education and is not medical advice. Abbreviation use varies between institutions; always confirm in context.