Maximum Limits on Lifetime Health Benefits May Provide Minimal Protection

08/01/08 | Comment (0)

(From Brigette Courtot, Policy Analyst National Women’s Law Center)

Does your health coverage have a lifetime maximum? Is it adequate? (If you’re already stumped, a lifetime benefit maximum or cap is the maximum amount of money an insurer will pay for healthcare services over the course of the insured person’s lifetime.) Granted, most insured Americans probably haven’t thought too much about this issue. But in 2007, 55 percent of people with job-based coverage had a lifetime limit on health benefits, an increase from 2004. Nearly a quarter of all workers had a lifetime benefit limit of $2 million or less. If $2 million seems like a lot of money, consider these eye-opening estimates of lifetime costs for certain illnesses and injuries:

Chances are you know someone who has suffered from one of these conditions. Maybe you know a family whose members have battled two or more of them. Throw in several years’ worth of more common medical costs — broken bones, rounds of antibiotics, asthma treatments, hearing aids — and it becomes easy to see how a $2 million limit wouldn’t cut it for families that experience major medical problems. Moreover, if health care costs continue to grow by leaps and bounds while lifetime benefit limits remain at levels set in the 1970s, even those with more minor medical costs could find themselves bumping up against lifetime limits.

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