What costs count toward the out-of-pocket maximum for Medicare Advantage (MA) Plans? The Out-of-Pocket Maximum includes any costs paid toward the plan, such as plan premiums and health care expenses. The Out-of-Pocket Maximum includes costs the member pays for any Medicare-covered Part A or B services but does not include the cost of any plan premiums. All Out-of-Pocket costs paid toward health care and prescription drug expenses would count toward the Out-of-Pocket Maximum.

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