Medigap out-of-pocket (MOOP) limit is an important part of your Medigap plan that saves you from having to pay huge medical bills. If you go through a major medical event without MOOP limits, you could have to pay huge amounts of money out of your own pocket — especially if you need expensive treatments or spend a long time in the hospital.

Below, this supplemental insurance broker in La Crosse, Indiana is going to explain how these limits work, and how they can help you keep your healthcare costs manageable.

MOOP limits protect you from high medical costs.

MOOP limits are exactly what they sound like. They set a maximum limit on how much money you will have to pay out of your own pocket for covered medical services in a year. Once you have reached the MOOP limit, your Medigap plan covers all the remaining costs for the year.

Without a MOOP limit, there is no ceiling on how much you might need to pay, and this kind of protection is extremely important for Americans because healthcare in our country is very expensive. As a matter of fact, Medicare beneficiaries spent an average of $5,460 from their own pockets on healthcare costs in 2016, and this number can be even higher for people who have chronic conditions.

The unique benefits of Plans K and L.

Medigap Plans K and L are the only two Medigap plans with cost-sharing. Cost-sharing is when the insurance company pays a percentage of your medical services, and you pay the rest up to your MOOP limit.

Plan K is a good option if you want a plan with lower monthly premiums and you are okay with paying slightly more out of pocket during the year. It covers 50% of the cost of most medical services, including doctor visits, hospital stays, and other Medicare-approved services. Once you reach your MOOP limit, your plan pays for everything else for the rest of the year.

Plan L gives you more coverage than Plan K. It covers 75% of the cost of most medical services, and it also has a lower MOOP limit. This plan is a good option if you want more financial protection upfront while keeping your premiums as low as possible.

Medigap Plan K has a MOOP limit of $7,220 in 2025, whereas Plan L has a lower MOOP limit of $3,610.

These limits can look very high, but they are there to save you from crushing medical bills, especially if you need frequent or expensive medical care. If these numbers look confusing or overwhelming, a supplemental insurance broker in La Crosse, Indiana can explain everything and help you choose the plan that best matches what you are looking for.

Get the best Medigap plan based on your needs and budget.

When looking at a Medigap plan, you need to look at more than its MOOP limits. You also need to consider your health and your budget.

For example, if you are one of the 69% of Medicare beneficiaries who are living with two or more chronic conditions, you probably visit the doctor frequently or need regular treatments. In this case, Plan L can be your best option because it covers more of your medical costs and has a lower MOOP limit. But if you are in good health and you want lower monthly premiums, Plan K could be a better option for you.

Your budget should also be a factor in your decision. Plans with higher premiums can be expensive at first, but they can save you thousands of dollars in the long term by limiting your out-of-pocket costs.

An experienced supplemental insurance broker in La Crosse, Indiana can help you compare different Medigap plans and find the one that offers the best balance of coverage and cost.

Looking for a Supplemental Insurance Broker in La Crosse, Indiana?

Are you ready to work with an experienced supplemental insurance broker in La Crosse, Indiana who can help you find the best Medigap plan with the right MOOP limit for your needs? If so, Senior Care Insurance Services is here to assist you. Contact us today to get started.