Accident & Health FundamentalsQuestion 24 of 315
With respect to Essential Health Benefits on an ACA-compliant plan, an insurer may impose:
a.A $250,000 annual cap on hospital benefits
b.No annual or lifetime dollar limits on Essential Health Benefits
c.A $1,000,000 lifetime cap
d.Only an annual cap, but no lifetime cap
Explanation
The ACA prohibits both annual and lifetime dollar limits on Essential Health Benefits. Non-essential benefits may still be subject to limits, but the ten categories of Essential Health Benefits (hospitalization, prescription drugs, maternity, etc.) must be offered without dollar caps.
Law Reference: ACA – annual & lifetime limits (42 U.S.C. §300gg-11)Practice all 315 questions free — no signup required.
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Sen Lin, PrepPass Founder · Verified against California Life & Health Insurance License Exam · How we review
Reviewed by John Zihao Zhang — California-Licensed Life Insurance Agent (CA Dept. of Insurance License #4396095 — verify)