Lifetime Maximum is another way of saying Lifetime Limit.
It is a cap on the total lifetime benefits you may get from your insurance company. It was a way for insurance companies to reduce their risk.
In the past, insurance companies imposed a total lifetime dollar limit on benefits. A lifetime cap of $1 or $2 million was common.
In some cases, lower limits were placed on specific benefits such as on organ transplants.
In other cases, limits were placed on the amount the insurance company would pay in a plan year.
After a limits were reached, the insurance company would no longer have any responsibility to pay for additional services.
♦ The Affordable Care Act (Obamacare) changed this in a positive way.
Insurance companies can no longer 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.
They can no longer set a yearly dollar limit on what they spend for your coverage.
The exception is that they can still put yearly or lifetime dollar limits on spending for health care services that aren't considered essential health benefits.
• Minimum Essential vs. Essential Health Benefits
• Minimum Value