Frequently Asked Questions > Maximum Out of Pocket (MOOP)
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What is meant by Maximum Out of Pocket?
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In New Jersey, all plans must have a set Maximum Out of Pocket amount, or "cap", which is an annual maximum amount that members can be required to pay (if they incur enough claims). Once the Maximum Out of Pocket amount is reached, most plans typically pay claims at 100% for the remainder of the calendar year.
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