Welcome back to Live Rich Retire Rich.

Last week we talked about preparing for disruption. How your finances need to be resilient in a world that changes fast.

This week, I want to zoom in on a different kind of disruption. One that doesn't warn you. One that doesn't care if you had "plans."

A medical year.

You probably know what your monthly premium is. Most people can tell you that number without checking.

But the number that quietly decides whether a medical situation becomes a financial crisis is not your premium.

It's your out-of-pocket exposure.

And if you've never planned for a year where your deductible, copays, coinsurance, prescriptions, imaging, and follow-up care stack on top of each other… you're not alone. But you are vulnerable.

You'll walk away from this with clarity and a plan you can actually implement.

MOOP = Maximum Out-of-Pocket.

It's the most you should have to pay in a year for covered, in-network services, depending on your plan type.

The reason I'm emphasizing this is simple:

You can feel "insured" and still be responsible for thousands.

And those thousands can quickly become medical debt, which too many households end up covering with a credit card at 20%+ interest because they didn't have cash ready.

That's not a "bad with money" problem. That's a planning problem. And it's fixable.

When people picture a costly medical year, they imagine a dramatic event: a surgery, an accident, an ER visit.

But many expensive medical years are quieter than that:

None of this is "rare." It's life. Which is why you plan for it like an adult who protects their future.

This is where people get tripped up.

Your deductible is what you pay before insurance starts sharing costs. Your MOOP is the maximum you pay for covered in-network care in that plan year.

So even if your deductible is "only" $2,000, your MOOP might be $6,000, $8,000, or more. Copays and coinsurance keep adding up until you hit that cap.

And many plans have separate rules for in-network vs out-of-network, prescriptions vs medical services, and "covered" vs "not covered" services. So MOOP is powerful, but it's not magic. The fine print matters.

I'm not sharing this to overwhelm you. I'm sharing it because you need a baseline.

If you have coverage through work or an ACA plan: The maximum allowable MOOP for an individual in 2026 can be as high as $10,600 (and $21,200 for family coverage). Many employers set lower MOOPs, but don't assume. Confirm.

If you're in Medicare Advantage: Your in-network MOOP may be as high as $9,250 in 2026. Some plans are lower. But even at half that, you could still face $4,000–$5,000 of out-of-pocket costs in a medical year.

If you're in Original Medicare: Original Medicare (A + B) does not cap what you could owe the way Medicare Advantage does. Under Part B, you may owe 20% coinsurance for many services, with no annual MOOP built in. That's why many people pair Original Medicare with a Medigap policy to limit exposure.

Different paths. Different risk profiles. Same truth: You need a plan.

Your emergency fund should be able to cover your household MOOP for two years.

Why two? Because illness and injury don't follow the calendar.

If you have a medical event in October and hit your MOOP by December, and you need continuing care into January, your out-of-pocket costs can reset. That's how people get financially wrecked even when they're insured. They didn't plan for the calendar reset.

So ask yourself honestly: If our household hit our MOOP this year, and again early next year, do we have the cash for that?

If the answer is no, it doesn't mean you failed. It means you just found your next savings target.

Pull your plan Summary of Benefits, your insurance portal, or your plan ID card info and find:

If you have family coverage, confirm: Is the MOOP per person, or combined? Can one person's spending hit the entire family MOOP, or is there an individual cap?

This is where people get surprised. Don't be surprised.

Most households lump all emergencies into one account and hope it covers everything. I prefer two buckets:

Bucket 1: Life disruption fund. Job loss, car repairs, home repairs, travel emergencies.

Bucket 2: Medical year fund. This fund has one job: cover deductible + copays + coinsurance + prescriptions up to your MOOP.

Even if you start this fund with $250, it changes your nervous system. Because now you're not hoping. You're preparing. And that changes everything when life gets loud.

I love a healthy lifestyle. I'm all for it. But health isn't a guarantee. It's a season.

Even very healthy people can have accidents, pregnancy-related costs, unexpected diagnoses, sports injuries, or complications that require follow-ups.

Planning for a medical year is not pessimism. It's maturity.

One of the most sobering patterns in personal finance is that medical debt can happen to people who look stable on paper. It's not always about income. It's often about timing, lack of liquid cash, not understanding plan rules, and trying to "float" costs on credit.

And once medical costs hit a credit card, they become even more expensive. I'd rather you save $25/week now than pay 24% APR later.

You don't need to fear a medical year. You need to plan for it.

Hope for the best. Plan for the worst. That's not negativity. That's power.

See you next Week,
With love and abundance,
Najma Zanelli
Explore Offerings
Founder, NAZ Global Consultancy
Follow me on IG: @najma_zanelli
Email: [email protected]

P.S. If you love someone who has "good insurance" but no savings, send this. One number can change how a family prepares.