Out-of-Pocket Maximum Amounts Announced for 2026

The Department of Health and Human Services (HHS) recently announced the 2026 Benefit Parameters, outlining the maximum out-of-pocket (OOP) limits applicable to non-grandfathered plans for plan years beginning in 2026. Each year, these OOP maximums are adjusted for inflation. In 2023, HHS pledged to release the updated amounts “by January of the year preceding the applicable benefit year” and they have indeed stuck to that promise.

Under the Affordable Care Act (ACA), non-grandfathered health plans are required to comply with an overall annual limit on out-of-pocket expenses for essential health benefits, regardless of whether the plan is self-funded or fully insured. The current limits applicable to 2025 plan years are $9,200 for self-only coverage and $18,400 for family coverage. The 2026 limits will be increased to $10,150 for self-only coverage and $20,300 for family coverage, respectively.

June 26, 2025 UPDATE: HHS recently updated the 2026 out-of-pocket expense limitations, changing them to $10,600 for self-only coverage and $21,200 for family coverage. These revised limitations will supersede the previously announced limits of $10,150 and $20,300 for self-only and family coverage, respectively. 

Here's a summary of the amounts for traditional plans for the 2025 / 2026 plan years  for reference:

OOPMAXes - Annual Out of Pocket Maximums