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Ending Lifetime & Yearly Limits


By: healthcare.gov

The health care law stops insurance companies from limiting yearly or lifetime coverage expenses for essential health benefits.

Lifetime limits

Insurance companies can’t set a dollar limit on what they spend on essential health benefits for your care during the entire time you’re enrolled in that plan.

Yearly limits

Insurance companies can’t set a yearly dollar limit on what they spend for your coverage.

Does this apply to my plan?

Protections against lifetime limits on coverage apply to all individual and job-based health plans, including grandfathered plans.

Protections against annual limits apply to most health plans, but they don’t apply to grandfathered individual health plans. Check your plan’s materials to find out if your health plan is grandfathered.

Are there any exceptions I should know about?

Insurance companies can still put yearly or lifetime dollar limits on spending for health care services that aren't considered essential health benefits.