Out-of-Pocket Maximums and Deductible Limits For 2023


Each year the ACA sets new limits for out-of-pocket maximums and deductibles. Here are the limits for 2023 plans for individuals and families.[1][2][3]

  • For 2023, your out-of-pocket maximum can be no more than $9,100 for an individual plan and $18,200 for a family plan before marketplace subsidies. These numbers have been revised up for 2023, they were slightly lower, $8,700 and $17,400 respectively in 2022.
  • For 2023, your maximum deductible is the same as the out-of-pocket maximum.

NOTE: The individual limit applies to each individual in the plan. Thus, for 2023, even though the family limit is $18,200, no one member can occur more than $9,100 in covered expenses before the maximum is reached for that member.

NOTE: See Notice of Benefit and Payment Parameters for 2023 for final levels.

Maximums and Deductibles on HSA-Eligible Plans in 2023

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 2023.

Minimum Deductible for HSA Eligibility 2023

  • $1,500 for self-only coverage ($100 increase from 2022)
  • $3,000 for family coverage ($200 increase from 2022)

NOTE: $3,000 for embedded individual deductible ($100 increase from 2022)

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 2023

  • $7,500 for self-only coverage ($450 increase from 2022)
  • $15,000 for family coverage ($900 increase from 2022)

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 than 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.”

HSA Contribution Limit for 2023

  • $3,850 for self-only coverage ($200 increase from 2022)
  • $7,750 for family coverage ($450 increase from 2022)

NOTE: 55 plus can contribute an extra $1,000.

TIP: See Rev. Proc. 2022-24 for final HSA levels.

Article Citations
  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.

Author: Thomas DeMichele

Thomas DeMichele is the head writer and founder of ObamaCareFacts.com, FactsOnMedicare.com, and other websites. He has been in the health insurance and healthcare information field since 2012. ObamaCareFacts.com is a...

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