Under the Affordable Care Act, health insurers cannot set a dollar limit on what they spend on essential health benefits for an insured individual’s care either each year or during an insured person’s life. The protections against such limits on coverage apply to all individual and job-based health plans, including grandfathered plans. But the annual limits do not apply to individual health plans that are grandfathered and health insurers can set annual and lifetime dollar limits on spending for health care services that aren’t considered essential health benefits.
