Accident & Health FundamentalsQuestion 24 of 315
With respect to Essential Health Benefits on an ACA-compliant plan, an insurer may impose:
a.A $1,000,000 lifetime cap
b.A $250,000 annual cap on hospital benefits
c.No annual or lifetime dollar limits on Essential Health Benefits
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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