Lifetime limits

Summary

A group health plan may not establish any lifetime dollar limits on the value of Essential Health Benefits for any individual under the group health plan.

A group health plan may impose lifetime limits on the dollar value of specific covered benefits that are not “essential health benefits” to the extent that those limits are not otherwise prohibited under federal or state law.

Lifetime and Annual Limits Under the Affordable Care Act

Under health reform, lifetime and annual dollar limits for all policies were eliminated in 2014.