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Article | Insider

HHS and CMS release 2026 out-of-pocket expense limits

By Maureen Gammon and Benjamin Lupin | October 18, 2024

Out-of-pocket maximums for non-grandfathered U.S. health plans have been adjusted upward for inflation for plan years beginning in 2026 — by 10.3%.
Benefits Administration and Outsourcing Solutions|Health and Benefits|Ukupne nagrade
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The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have issued the 2026 annual dollar limits on cost sharing. The maximum annual limitation on cost sharing that a group health plan can impose for 2026 is $10,150 for individual coverage and $20,300 for family coverage (compared with $9,200 and $18,400, respectively, for 2025) — an increase of 10.3%.

Note: These out-of-pocket maximums are different from the IRS limits on health savings account (HSA)-qualified high-deductible health plans. For information on HSA cost-sharing limits for 2025, see the Insider article “IRS announces 2025 HSA, HDHP and EB-HRA dollar limits.” The HSA cost sharing limits for 2026 will be released in spring 2025.

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Senior Regulatory Advisor, Health and Benefits

Senior Regulatory Advisor, Health and Benefits

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