What is the maximum out-of-pocket on Medicare Advantage plans?

The full explanation

Original Medicare (Parts A and B) has no out-of-pocket maximum. You could theoretically face unlimited costs in a bad year. That's one reason Medicare Advantage exists. By law, every Medicare Advantage plan must include an annual out-of-pocket maximum, which is a cap on what you pay before the plan covers 100 percent of covered costs for the rest of the year.CMS sets a ceiling on how high that cap can go, and it adjusts most years. Medicare plan networks, drug coverage, and costs can change each year. Before you enroll, check your doctors, prescriptions, pharmacies, and current plan documents. The specific numbers for the current plan year are published by CMS and can change, so always verify the current figures.Here's the important nuance. Plans can set their caps lower than the CMS ceiling, and many do, sometimes significantly lower. Medicare plan networks, drug coverage, and costs can change each year. Before you enroll, check your doctors, prescriptions, pharmacies, and current plan documents. That's a meaningful difference if you have a serious health event.Also worth knowing: out-of-pocket maximums typically apply to Medicare-covered services only. Drug costs, additional benefits not covered by Original Medicare may or may not count toward the cap depending on the plan. Read the plan documents carefully, or ask an agent to walk you through exactly what counts.