Glossary
MOOP (Maximum Out-of-Pocket)
The yearly cap on what you'll spend on covered Medicare Advantage services — Original Medicare has no MOOP.
Also known as: Maximum Out-of-Pocket, annual out-of-pocket maximum
What is it?
Every Medicare Advantage plan has an annual maximum out-of-pocket (MOOP) limit for in-network covered services. Once you hit it, the plan pays 100% for the rest of the year.
Why does it matter?
Original Medicare has no out-of-pocket cap — TFL is what protects you from that. Under MA, the plan's MOOP is your safety net (with TFL still wrapping around copays).
When you'll encounter it
When comparing MA plans.
Impact on Medicare
N/A — Original Medicare has no MOOP.
Impact on TRICARE For Life
On Original Medicare, TFL acts as your de-facto MOOP by covering nearly all Medicare cost-shares.
Common misconceptions
- "MOOP includes my Part B premium." — It does not. Premiums are separate.
Related glossary terms
Official sources
Last reviewed January 2026 against the 2026 Medicare & You and TRICARE For Life handbooks.