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Can my student health insurance plan set annual dollar limits on how much it will pay out to cover essential benefits?

Q. Can my student health insurance plan set annual dollar limits on how much it will pay out to cover essential health benefits?

A. No, it cannot. The ACA banned individual and small group plans from implementing annual or lifetime dollar limits on essential health benefits, and student health plans are regulated as individual market coverage.

The bulk of the ACA’s regulations took effect in 2014, but annual limits began phasing out before then. However, student health plans were allowed to have lower annual limits than other individual market plans prior to 2014. Starting in 2014, however, annual limits were banned altogether, and that regulation extended to student health plans as well as the rest of the individual market.

Student health plans have been fully compliant with the ACA since 2014. Essential health benefits are covered with no annual or lifetime dollar limits on benefits.

Read more FAQs about health reform, and student health insurance.