Out-of-Pocket Maximums and Deductible Limits For 2021

Each year the ACA sets new limits for out-of-pocket maximums and deductibles. Here are the limits for 2021 plans for individuals and families.^[1][2][3]

• For 2021, your out-of-pocket maximum can be no more than $8,550 for an individual plan and $17,100 for a family plan before marketplace subsidies. These numbers have been revised up for 2021, they were slightly lower, $8,150 and $16,300 respectively in 2020.
• For 2021, your maximum deductible is the same as the out-of-pocket maximum.

TIP: See Notice of Benefit and Payment Parameters for 2021 for final levels.

Maximums and Deductibles on HSA-Eligible Plans in 2021

The maximum and deductible requirements for HSA qualifying plans are not the same as maximums and deductibles on health plans in general. Below are the HSA limits for 2021.

Minimum Deductible for HSA Eligibility

• Self-only: $1,400
• Family: $2,800

NOTE: The minimum deductible, which is the minimum deductible your High Deductible Health Plan must have after cost assistance.

Maximum Out-of-Pocket Limit for HSA Eligibility

• Self-only: $7,000
• Family: $14,000

NOTE: The maximum out-of-pocket is the highest maximum a plan can have to qualify for an HSA.

TIP: The maximums are slightly lower on HSA compatible plans then they are in general on health plans. This has to do with the fact that the rates are raised by different mechanisms. The difference allows for non-HSA compatible high deductible plans. Thus, if you want an HSA, make sure your plan is “HSA Eligible.”

1. out-of-pocket maximum limit. HealthCare.Gov.
2. See Notice of Benefit and Payment Parameters for 2020 for final levels.
3. See Revenue Procedure 2020-32 for final HSA levels.