Lifetime Maximum

Updated: 09 June 2023

What Does Lifetime Maximum Mean?

A lifetime maximum is the cap on the total benefits a policyholder may receive from their health insurance company over the life of the policy. Once it is reached, the insurer is no longer liable to pay for covered services.

Insuranceopedia Explains Lifetime Maximum

For instance, an insurer may impose a total lifetime dollar limit of $1 million dollars on all health benefits or choose certain lifetime limits for specific benefits. However, the Affordable Care Act prohibits limits on many benefits. However, there are two exceptions: First, insurers can cap lifetime benefits for non-essential health care services, and grandfathered individual policies do not need to follow the regulations on annual limits.

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