Medical Benefit carriers can cap how much they will pay out in a given year for medical expenses and or have a lifetime maximum payout exclusion.
Most Private health plans come standard with an annual payout of $1 Million but you can find a $2 Million lifetime maximum policy in the private marketplace.
The drawback to lifetime maximums is that these types of policies are not meant for long-term or chronic ongoing medical treatment.
After a medical diagnosis, it would be in the policy holder’s best interest to seek coverage through the Affordable Care Act’s (ACA) marketplace which offers more comprehensive and affordable coverage for those with preexisting conditions.
A pre-existing condition is a health condition that exists before you enroll in a new health insurance plan. Many insurance companies will not cover expenses related to a pre-existing condition for a period of time after you enroll, or in some cases, for the life of the policy. This is called a pre-existing condition exclusion. If you have a pre-existing condition, it’s important to understand how your insurance company handles these exclusions.
Some things to keep in mind include:
- Whether there is a waiting period for coverage?
- What types of services are covered?
- Whether there are any limitations on coverage?
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