What is the 2027 Medicare Advantage MOOP in Maricopa County?
In-network out-of-pocket maximums on Maricopa County Medicare Advantage plans range from $2,000 to $8,900 for 2027, with an average of $4,896 across the 52 plans in the CMS 2027 landscape.
These figures exclude Special Needs Plans. The out-of-pocket maximum is the most you pay in a year for covered in-network Part A and Part B services; it does not include your plan premium, your Part B premium or Part D drug costs, which have their own $2,400 cap for 2027.
| Plan type | Plans | $0 Part C premium | Average in-network out-of-pocket max |
|---|---|---|---|
| HMO | 29 | 28 | $4,305 |
| PPO | 14 | 14 | $6,046 |
| HMO-POS | 7 | 7 | $4,564 |
| Regional PPO | 2 | 1 | $6,575 |
How the out-of-pocket maximum works
Every Medicare Advantage plan must cap what you pay for covered in-network medical care each year. Once your copays and coinsurance reach the cap, the plan pays 100% of covered in-network services for the rest of the calendar year. PPO plans also have a separate, higher combined cap that includes out-of-network care.
What changes your number
The plan you pick. HMO plans in Maricopa County average $4,305 for 2027, while PPO plans average $6,046. A lower cap often comes with a tighter network. Across the county the average rose for 2027, so check your Annual Notice of Change even if you plan to stay put.
In neighboring Pinal County the 2027 range is $2,000 to $8,900, with an average of $4,980.
What to do next
Ask yourself whether you could pay the full cap in a bad year. If not, a plan with a lower cap or a hospital indemnity policy may be worth comparing. Use the plan finder by ZIP, or book a review with us in Chandler.
Related questions
What is the 2027 Medicare Advantage MOOP in Maricopa County?
In-network out-of-pocket maximums on Maricopa County Medicare Advantage plans range from $2,000 to $8,900 for 2027, with an average of $4,896 across the 52 plans in the CMS 2027 landscape.
Does the out-of-pocket maximum include prescription drugs?
No. Part D drug costs have their own cap: $2,100 in 2026 and $2,400 in 2027 according to the CMS landscape.
Does the out-of-pocket maximum include premiums?
No. Plan premiums and your Part B premium do not count toward it.
What is the lowest out-of-pocket maximum in Maricopa County for 2027?
$2,000 in network, on the plans with the lowest cap in the CMS 2027 file.
Do PPO plans have higher out-of-pocket maximums than HMO plans?
In Maricopa County for 2027, yes on average: HMO plans average $4,305 in network and PPO plans $6,046. PPO plans also have a separate, higher combined cap that includes out-of-network care. A lower cap often comes with a tighter network, so weigh the cap against the doctors you want to keep.
What is the 2027 Medicare Advantage out-of-pocket maximum in Pinal County?
Pinal County plans range from $2,000 to $8,900 in network for 2027, with an average of $4,980 across 47 plans, excluding Special Needs Plans, according to the CMS CY2027 landscape. Check which county your ZIP code is in, because the plan list differs.
Does Original Medicare have an out-of-pocket maximum?
No. With Original Medicare alone you generally pay 20% of approved Part B costs with no yearly cap. That is why many people on Original Medicare add a Medicare Supplement, which covers most of those costs, while Medicare Advantage plans build in their own yearly cap.
Does out-of-network care count toward the out-of-pocket maximum?
On HMO plans, out-of-network care is generally not covered except for emergencies and urgent care. PPO plans have two caps: the in-network maximum shown on this page and a higher combined maximum that includes out-of-network care. Check both numbers if you see doctors outside the network.
What happens after I reach my out-of-pocket maximum?
The plan pays 100% of covered in-network Part A and Part B services for the rest of the calendar year. You still pay your premiums and any drug costs, which have their own cap. The count starts again on January 1, so a costly year does not carry into the next.
Sources
- CMS Medicare Advantage and Part D Landscape, Contract Year 2027 Centers for Medicare & Medicaid Services
Please note: We do not offer every plan available in your area. Currently we represent 34 organizations which offer 64 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.Rise Up Benefits Group is not connected with or endorsed by the United States government or the federal Medicare program. Medicare has neither endorsed nor reviewed this information.
In clients' words
What working with Viola looks like
Rise Up Benefits Group is absolutely outstanding! Viola and her team are hands down amazing. Knowledgeable, professional, and genuinely caring. They take what could be a complicated process and make it simple and easy to understand. Their expertise with Medicare enrollment gives you complete confidence in your decisions. I truly appreciate how they take the time to explain every option clearly and with patience. I highly recommend Rise Up Benefits Group to anyone needing trusted guidance with Medicare, they’re the best!
Verbatim client reviews from the agency's public profiles (5.0 stars from 49 Google reviews). Read all reviews.
Go deeper
More in medicare plans in maricopa county
All answers · Free Medicare workshops in Chandler · Official CMS videos and forms