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Lifetime Maximum

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Definition: The lifetime maximum insurance benefit is the maximum amount that your insurance company will pay during your lifetime. Although many types of insurance policies use lifetime maximums such as long term care insurance and dental insurance, a lifetime maximum benefit is generally associated with health insurance.

It is important to know that the lifetime maximum benefit in a health insurance policy can vary. The range of lifetime maximum benefit limits can vary widely... they can be very low such as only $30,000 and range all the way up to unlimited or no lifetime maximum.

Having a higher lifetime maximum insurance benefit is more important than ever since medical procedures are constantly rising. Take for example the estimated cost of caring for a patient with multiple sclerosis, which is about $2.2 million. Although a $1 million lifetime maximum benefit sounds like a lot, it obviously would not be enough to care for a patient with multiple sclerosis. Even the cost of less costly medical conditions can add up such as caring for a child with autism which is estimated at about $300,000. Since the lifetime maximum includes all care, including medications, it is easy to see how quickly a $1 million lifetime maximum benefit can be used.

One should know the lifetime maximum benefit in their health insurance plan. Most employer sponsored health care plans have lifetime maximum benefits and it is one area that employers are adjusting to provide cheaper insurance (if they can find plans with a lower lifetime maximum benefit they can provide insurance to their employees at a cheaper cost). Plans with no lifetime maximum benefit can be found and should be obtained if one can afford it. If finding a plan with a lifetime maximum benefit would be too expensive, one should purchase a health insurance plan with the largest lifetime maximum benefit available.

Examples:
Linda received a phone call from her health insurance company that she was about to reach her lifetime maximum benefit. The insurance company explained that once she reached her lifetime maximum benefit they would no longer cover her treatment or medication costs because her insurance benefits would not longer be available.
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