STOP-LOSS (MOOP)
Back to GlossaryDefinition
Another term for the plan’s out-of-pocket maximum; once reached, the plan pays 100% of covered in-network costs for the rest of the plan year.
Summary
Stop-Loss (MOOP) is simply another name for your health insurance plan's out-of-pocket maximum - the most money you'll have to pay for covered medical services in a year. Think of it as your financial 'safety net.' Once you've paid this amount through deductibles, copays, and coinsurance, your insurance plan takes over and pays 100% of your covered in-network medical expenses for the remainder of that plan year. This protects you from catastrophic medical bills.
Usage Context
Essential when comparing health insurance plans, understanding financial protection limits, calculating potential healthcare costs, and making informed decisions about medical care timing and provider choices.
Common Confusions
- Thinking stop-loss and deductible are the same thing
- Believing premiums count toward the stop-loss limit
- Assuming out-of-network costs always count toward the limit
- Confusing calendar year versus plan year timing
- Not understanding that non-covered services don't count toward the limit
