💡 MOOP vs. Deductible: What’s the Difference in Your Medicare Plan?

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🧾 What Is a Deductible?

A deductible is the amount you pay before your insurance coverage begins paying for certain services.

💰 Example:
If your plan has a $250 deductible for medical services, you’ll pay the first $250 out of pocket. After that, your plan begins to share costs with you — typically through copays or coinsurance.

Deductibles reset every year and can apply separately to different parts of your coverage (like medical vs. drug benefits).

✅ Key takeaway:
A deductible is your starting line — what you pay upfront before your plan helps cover costs.

🛡️ What Is MOOP (Maximum Out-of-Pocket)?

Your Maximum Out-of-Pocket (MOOP) limit is the most you’ll have to pay for covered medical services in a calendar year.

Once you reach that limit, your plan covers 100% of covered medical expenses for the rest of the year.

💸 Example:
If your MOOP is $5,000, and you’ve paid $5,000 total through deductibles, copays, and coinsurance, you won’t pay another dime for covered services that year.

🧩 Key takeaway:
MOOP is your safety net — it protects you from unlimited medical costs.

⚖️ How They Work Together

Here’s how both might show up in the same plan year:

1. You first pay your deductible (say, $250).
2. After that, you share costs with your plan through copays or coinsurance.
3. All those payments — including your deductible — add up toward your MOOP.
4. Once you hit your MOOP, your plan pays 100% for covered services for the rest of the year.

➡️ The deductible is part of your path toward the MOOP, but the MOOP caps your total financial responsibility.

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🔍 Why It Matters When Comparing Plans

Both numbers help you understand risk and predictability:

• 📉 A lower deductible means your coverage kicks in sooner.
• 🧭 A lower MOOP means you’re better protected if you have a serious illness or high medical costs.
• ⚙️ Some plans have no deductible but a higher MOOP, and vice versa — which is why it’s important to compare them together.

The best choice depends on your health needs, how often you use care, and your comfort level with potential out-of-pocket costs.

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🤝 Need Help Reviewing Your Plan?

Understanding the difference between deductibles and MOOP can make a big difference when choosing your Medicare coverage.

If you’d like a personalized comparison of your 2026 options, contact Thompson Medicare Brokerage today — I’ll help you find a plan that fits your budget and your health needs. 🩵

Contact Benjamin at Thompson Medicare Brokerage:

• Phone: 855-982-6525
• Email: benjamin@thompsonmedicare.com
• Consultation: Schedule here.

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✅ Looking Ahead…

Medicare isn’t just about picking a plan — it’s about having someone in your corner who truly prioritizes your needs. At Thompson Medicare Brokerage, I focus on clarity, honesty, and guidance you can trust.

I’m not here to steer you toward the plan that benefits me the most. My goal is to help you find the coverage that fits your health, lifestyle, and budget. Whether it’s Medicare Advantage, Part D drug coverage, Medigap, VA coordination, or Medicaid overlap, I’ll help you navigate the options — not just during AEP, but all year long.

We’ll go through your doctors, prescriptions, and benefits together so you can make confident, informed decisions. Still weighing your options? Check out my other Medicare articles or visit the Broker Services page to see how I support clients before, during, and after enrollment.

When you’re ready, let’s connect. I’ll take the time to understand your full situation so we can choose coverage that gives you peace of mind — not just another stack of paperwork.