A dollar limit on how much the insurance company will pay in your lifetime. An insurer may, for example, cover up to $1 million over your lifetime. Above this they will pay nothing.
A cap on the total lifetime benefits you may get from your insurance company. An insurance company may impose a total lifetime dollar limit on benefits (like a $1 million lifetime cap) or limits on specific benefits (like a $200,000 lifetime cap on organ transplants or one gastric bypass per lifetime) or a combination of the two. After a lifetime limit is reached, the insurance plan will no longer pay for covered services.
Many health insurance plans have historically placed dollar limits upon the claims that the insurer will pay over the course of an individual's life. The ACA prohibits lifetime limits on benefits beginning for plan years that start on or after September 23, 2010.
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