Are you a Texas resident? If so,
read about Medicare in Texas here.

I’ve Noticed That Medicare Advantage Plans Have a Maximum Out-Of-Pocket Limit. Is That a Deductible?

Find affordable Medicare plans

Get Started

The out-of-pocket maximum for Medicare Advantage plans is not a deductible; it is the highest yearly amount you will have to pay out of pocket for covered health-care services. This spending maximum is one important difference between Medicare Advantage plans and the traditional fee-for-service Medicare program; Original Medicare doesn’t have a yearly cap on your health-care costs.

This yearly cap does not include monthly premiums, but annual deductibles, coinsurance, and copayments may all count towards this maximum limit. The out-of-pocket maximum may be different for each individual Medicare Advantage plan and can change from year to year. Once you have reached the plan’s spending limit for that year, then your Medicare Advantage plan will cover 100% of covered health-care costs for the rest of the year.

Need help?

Call to speak with a licensed
insurance agent now.

Touch to Call

1- TTY users 711

Or, enter your zip code to shop online

Enter your zip code to shop online

Browse Plans
Was this article helpful?
Thank you for your feedback!

eHealth's Medicare website is operated by eHealthInsurance Services, Inc., a licensed health insurance agency doing business as eHealth. The purpose of this site is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company. eHealth and Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. We offer plans from a number of insurance companies.