The Affordable Care Act (“ACA”) Maximum Out of Pocket Limits (“MOOP”) Explained

Under the Affordable Care Act (“ACA”), aka Obamacare, limitations on cost sharing apply for plan or policy years that begin in or after 2017. This requirement applies to all non-grandfathered group health plans, including non-grandfathered self-funded and large group health plans. This requirement does not apply to transitional relief and retiree only plans.

The Annual Maximum Out of Pocket Limits (“MOOP”) for ACA Health Plans are as follows (Example: Standard Silver 70 Metallic TIER, which is the most purchased TIER thru 2020-2021, and since ever more often into the Bronze 60 TIER that for many helps in keeping some degree of control over the ever-escalating health plan premium costs into 2022-2023 and beyond.

For more on this see my published article by clicking here.


Standard Silver 70 TIER 2021-2022 2023
Individual $8,200 $8,750
Family $16,400 $17,500


Standard Bronze 60 TIER 2021-2022 2023
Individual $8,200 $8,200
Family $16,400 $16,400