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Under the ACA, do student health plans have lifetime dollar limits?

  • October 13, 2015

Q. I recently read about the graduate student at Arizona State who died of cancer in 2013 because his insurer capped how much the policy would pay out over a lifetime at $300,000. Ultimately Aetna relented, but it was too late.  Under the Affordable Care Act, can university health plans include lifetime dollar limits?

A. No, they cannot. In 2011 the government extended the consumer protection provisions in the ACA to students. As of April 2012, lifetime benefit maximums on essential health benefits were prohibited on all new and renewing student health plans (for non-student plans in the individual market, new and renewing policies had to eliminate lifetime benefit maximums in September 2010; the provision didn’t take effect until 2012 for student policies).

Annual limits on essential health benefits were phased out gradually on student health plans, and eliminated entirely as of January 1, 2014 for new and renewing student health insurance policies.

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