Maximum Out-of-Pocket Limit

This limit is set by Medicare Advantage Plan providers to ensure a cap is placed on how much you spend on out-of-pocket expenses each year. When it comes to Part D coverage, it is the maximum sum of out-of-pocket expenses you will incur in a year before catastrophic coverage comes into play.

Once the patient reached his maximum out-of-pocket limit for the year, he was relieved to learn that catastrophic coverage came into play to lower his costs dramatically.