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HHS Announces 2019 Out-of-Pocket Maximums


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
$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.