Content Overview
- Adverse Determination
- Annual Limits
- Case Manager
- Certificate of Creditable Coverage
- Coordination Of Benefits
- Co-Insurance
- Co-Pay
- Covered Charges
- Department Of Insurance
- Deductible
- Eligibility
- Experimental Treatment
- Explanation Of Benefits
- Extensions
- Fee-For-Service (Indemnity)
- Formulary
- Lifetime Limits
- HMO
- Medical Necessity (Medically Necessary)
- Out Of Network
- Out-of-Pocket Maximum (also known as "Stop Loss" or "Cap")
- Palliative Care
- POS
- PPO
- Renewability
- Pre-Existing Health Condition
- Stop Clause (also known as "Stop Loss Clause")
- Underwriting (What It Is And How It Works)
- U.S. Department Of Labor
- Usual, Customary and Reasonable "(UCR")
- Utilization Management
Glossary of Health Insurance Terms To Know
Lifetime Limits
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A lifetime maximum (also known as a "lifetime limit") is the maximum amount the insurance company will pay for health claims by any one insured during his or her lifetime. Once that cap has been reached, the insurer will not pay for any more health care - even if it for an illness which is already covered.
Health insurance companies often had lifetime maximums of $1,000,000 or higher. Under the Affordable Care Act (ACA or “Obamacare”) health plans issued or renewed on or after September 23, 2010, can no longer include a lifetime maximum.
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