What is a maximum benefit dollar limit?
The maximum benefit dollar limit refers to the maximum amount of money that an insurance company (or self-insured company) will pay for claims within a specific time period.
Maximum benefit dollar limits used to be commonplace, but the Affordable Care Act eliminated them in most cases for essential health benefits (grandfathered plans can still have annual maximum benefit dollar limits, but not lifetime limits; all other plans are prohibited from having lifetime or annual maximum benefit dollar limits on any essential health benefits).