See when your plan's cap protects you.
Educational estimate. Not insurance advice — confirm with plan documents.
We divide your plan's out-of-pocket maximum by your average monthly cost-sharing to estimate the month you'd reach the cap, after which the plan covers 100% of covered services.
Compare your real Medicare costs with our free tools.
The out-of-pocket maximum is the most an Advantage plan can cost you in copays and coinsurance in a year. This tool turns that abstract cap into something concrete: at your typical monthly cost-sharing, what month would you actually hit it? After that point, the plan pays 100% for covered services.
If a serious diagnosis would push you to the cap quickly, that’s a sign to weigh a lower-MOOP plan or Medigap. Compare options in the Advantage vs Medigap calculator.
In-network copays and coinsurance for covered medical services; premiums and drugs are usually separate.
The plan pays 100% of covered in-network services for the rest of the year.
Yes — CMS sets a maximum MOOP each year; many plans set theirs lower.
No — it's an educational estimate.