Lifetime Maximum (Multi-Benefit)

A combined lifetime maximum (multi-benefit) is a single limit that applies to multiple benefit categories over your lifetime. Instead of each service having its own separate lifetime maximum, this approach creates one shared total for several types of expenses, such as health, vision, and dental.

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This structure is common in guaranteed-issue and simplified health plans, where insurers control long-term risk while still offering broad coverage. Once the combined lifetime maximum is reached, no additional reimbursements are provided for any benefit included in that grouping.

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Example:

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If your plan has a $250,000 combined lifetime maximum for all health benefits, once you reach that total, future claims for any included services are not reimbursed.

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What to Watch For:

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Confirm which benefits are counted toward the shared total and track large claims over time to avoid reaching the lifetime cap unexpectedly.