When a member switches from one MA plan to another, what will happen to their MOOP expenses if they change carriers?

When a member switches from one Medicare Advantage (MA) plan to another, their out-of-pocket maximum (MOOP) expenses do not carry over to the new plan. Each MA plan has its own MOOP limit, which resets with the start of the new plan year upon enrollment in a different carrier. Therefore, any accumulated expenses towards the MOOP limit in the previous plan will not be counted or applied to the new plan's MOOP threshold.

This situation arises because each plan operates independently, with distinct coverage options, cost structures, and financial responsibilities. The purpose of the MOOP is to protect members from excessive costs within a specific plan year's framework, and switching carriers represents a fresh start regarding financial obligations under the new plan's rules. Consequently, the member would need to start accruing costs towards the new plan's MOOP from scratch, illustrating the importance of understanding how plan transitions affect financial responsibilities in Medicare Advantage coverage.