Overview
The Department of Health and Human Services has announced the final notice of increases to the out-of-pocket maximum dollar limits for plan years beginning January 1, 2019 (regulations available here). The table below shows the changes in out-of-pocket limits from 2017 to 2019. Notably, the 2019 amounts represent the largest increase in recent years with an increase of over 7% from the 2018 maximums.
| 2019 | 2018 | 2017 | |
| Self Only Coverage |
$7,900 | $7,350 | $7,150 |
| Coverage Other than Self-Only |
$15,800 | $14,700 | $14,300 |
Impact on High Deductible Health Plans
It is important to remember that the limits in the table above are not the same as the out-of-pocket limits for high deductible health plans (HDHPs) that qualify for health savings accounts (HSAs). At this time, the IRS has yet to announce any changes to the HDHP deductible and out-of-pocket limits or to the HSA contribution limits for 2019. However, the HHS and IRS rules often have to be coordinated to ensure coverage rates remain compliant with applicable minimums and maximums. HHS has issued some useful guidance on this interaction regarding HDHP plan designs with non-embedded out-of-pocket limits, which can be found here.
More information about the 2019 benefit and payment parameters can be found here. If you have any questions, please feel free to contact your MedCost Account Manager.