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Article | Insider

CMS releases 2027 out-of-pocket expense limits

By Maureen Gammon and Anu Gogna | February 13, 2026

The maximum annual limitation on cost sharing that a group health plan can impose on essential health benefits has been increased by 13.2% for 2027.
Benefits Administration and Outsourcing Solutions|Health and Benefits
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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 2027 annual dollar limits on cost sharing. The maximum annual limitation on cost sharing that a non-grandfathered group health plan can impose on essential health benefits for 2027 is $12,000 for individual coverage and $24,000 for family coverage (compared with $10,600 and $21,200, respectively, for 2026) — an increase of 13.2%.

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 2026, see the WTW Insider article IRS announces 2026 HSA, HDHP and EB-HRA dollar limits. The HSA cost sharing limits for 2027 will be released in spring 2026.

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Senior Regulatory Advisor, Health and Benefits

Senior Regulatory Advisor, Health and Benefits

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