A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1999.
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Medicare & Medicaid

Medicare & Medicaid

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What are the deadlines for the ACA’s open enrollment period?
A list of the open enrollment deadlines for enrollment in 2025 ACA-compliant health insurance in every state. Open enrollment runs from November 1 to January 15 in most states, but some state-run exchanges have different schedules.

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Featured
Will you receive an ACA premium subsidy?
See if you're eligible for the Affordable Care Act's premium tax credits (premium subsidies), how subsidies are calculated, and why they are more robust than they used to be.

lifetime maximum benefit (or maximum lifetime benefit)

What is a lifetime maximum benefit?

healthinsurance.org health insurance glossary

What is a lifetime maximum benefit?

Lifetime maximum benefit – or maximum lifetime benefit – is the maximum dollar amount a health plan will pay in benefits to an insured individual during that individual’s lifetime.

The ACA did away with lifetime benefit maximums for essential health benefits. Policies issued on or renewing after September 23, 2010 are required to have no lifetime benefit maximums on any essential health benefits covered by the plan.

Grandmothered and grandfathered plans do not have to cover all of the ACA’s essential health benefits, and neither do large group plans (in most states, “large group” means employers with 51 or more employees, but in Colorado, California, Maryland, New York, and Vermont, it only includes employers with 101 or more employees). But for essential health benefits that are covered by these plans, there cannot be any dollar limits applied to the total lifetime benefits.

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