The health care law stops insurance companies from limiting yearly or lifetime coverage expenses for
A set of 10 categories of services health insurance plans must cover under the Affordable Care Act. These include doctors’ services, inpatient and outpatient hospital care, prescription drug coverage, pregnancy and childbirth, mental health services, and more. Some plans cover more services.
Refer to glossary for more details.
Insurance companies can’t 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.
Insurance companies can’t set a yearly dollar limit on what they spend for your coverage.
Does this apply to my plan?
Protections against lifetime limits on coverage apply to all individual and job-based health plans, including grandfathered plans.
Protections against annual limits apply to most health plans, but they don’t apply to grandfathered individual health plans. Check your plan’s materials to find out if your health plan is grandfathered.
Are there any exceptions I should know about?
Insurance companies can still put yearly or lifetime dollar limits on spending for health care services that aren't considered essential health benefits.