In an April 30 fact sheet, the Centers for Medicare and Medicaid Services announced that the cost-sharing limit for individual and group health plans in 2022 will be $400 lower than initially projected. 

For 2022, the out-of-pocket limits will be $8,700 for single coverage and $17,400 for family coverage.

The proposed Notice of Benefit and Payment Parameters for 2022 was released back on November 20, 2020, and we find on page 209 of the 395-page document that the proposed limits were originally “$9,100 for self-only coverage and $18,200 for other than self-only coverage.” However, HHS Secretary Xavier Becerra said in an HHS press release that the government was lowering the limits by $400: “Families deserve to have access to health care coverage that doesn't break the bank. That's why today we're acting to lower consumers' maximum out-of-pocket costs by $400 and why President Biden has a plan to reduce families' health care costs for the long run.”

Note that the new limits are still an increase from the 2021 numbers.

Limits for Individuals with Cost-Sharing Reductions

The 2022 payment notice, also known as the “second 2022 Notice of Benefit and Payment Parameters final rule,” also tells us the new limits for those who qualify for a cost-sharing reduction through the marketplace:

Those with incomes above 250% of the Federal Poverty Level (FPL) do not qualify for a cost-sharing reduction.

HSA-Qualified High Deductible Health Plan Limits

We also have the updated HSA plan limits for 2022, as reported by the IRS in Revenue Procedure 2021-25. Next year, the minimum deductible on an HSA-qualified High Deductible Health Plan will remain at $1,400 for single coverage and $2,800 for family coverage in 2022; the out-of-pocket limit will increase from $7,000 to $7,050 for those with single coverage and from $14,000 to $14,100 for those with family coverage; and the contribution limit will increase from $3,600 to $3,650 for those with single coverage and from $7,200 to $7,300 for those with family coverage.

Obviously, the out-of-pocket limits on an HSA-qualified plan are significantly lower than for non-HSA plans, even after the reduction from $9,100 to $8,700 in 2022. This is something that agents will want to point out to clients who are weighing their options: not only do HSA-qualified plans allow eligible individuals to pay for medical expenses with tax-free dollars, they also offer better catastrophic protection than many of today’s copay plans.