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Health plans and insurance policies may no longer set lifetime or annual limits for essential health benefits. Previously, plans were allowed to set a lifetime limit — a cap on the dollar limit on what they would spend for covered benefits both annually, and during the entire time a person was enrolled in that plan. Consumers were then required to pay the cost of all care exceeding those limits.
Health plans are allowed to set annual dollar limits and a lifetime dollar limits on health care services that are not considered essential health benefits.
For more information on the Patient Protection and Affordable Care Act, visit healthcare.gov.
The Center for Consumer Information and Insurance Oversight (CCIIO) at CMS is the agency consumers can contact for help when they feel they have been inappropriately denied services or were inappropriately charged a co-pay or deductible counter to the Patient Protection and Affordable Care Act. They run a helpline at (887) 267-2323 ext. 6-1565, or can be reached by email at: firstname.lastname@example.org.