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Per-X-Years Limit

A per-X-years limit means a benefit can only be claimed once during a specified number of years. This rule applies to items or treatments that are not needed annually, such as hearing aids, orthotics, or major dental appliances.

Plans use these limits to manage costs for high-value or long-lasting services. The time frame varies by benefit - common examples include every two, three, or five years.

Example:

If your plan covers hearing aids up to $600 every four years, you can only make another claim after four full years have passed since the last reimbursement.

What to Watch For:

Track your purchase dates carefully. Submitting a claim too early, even by a few days, can result in denial.

Related Terms

Per Person / Per Family

Per person and per family describe how benefit limits, deductibles, or maximums are applied within a health or dental insurance plan. A per person limit means the specified amount applies individually to each insured member, while a per family limit represents the total combined coverage for all members under one policy.

Per Incident

Per incident refers to the way certain insurance benefits are calculated or limited based on each separate event, illness, or accident rather than by year or lifetime. When a benefit is paid “per incident,” it means you are eligible for reimbursement each time a new, distinct occurrence happens, up to the maximum amount specified for that type of claim.

Per-Visit Maximum

A per-visit maximum is the highest dollar amount your insurance plan will reimburse for a single appointment or treatment with a healthcare provider. If the provider charges more than this set amount, you are responsible for paying the difference. This type of limit is most common in extended health plans for paramedical services, such as physiotherapy, chiropractic care, massage therapy, or acupuncture.

Preventive (Dental Subcategory)

Preventive dental care focuses on maintaining oral health through regular cleanings, examinations, and minor treatments. It helps detect issues early, reducing the need for major dental work later. Services in this category include exams, X-rays, scaling, polishing, fluoride treatments, and sealants for children.

Provincial Coordination

Provincial coordination refers to the process of aligning private insurance benefits with the coverage provided by your provincial or territorial government health plan. It ensures that the public plan pays for all eligible expenses first, and your private insurance covers only the remaining costs that are not paid by the government. This coordination helps prevent duplicate payments while maximizing your overall coverage.

Relevant Plans

Plans that relate to Per-X-Years Limit

Alberta Blue Cross - Blue Assured - Basic

Alberta Blue Cross - Blue Assured - Basic

Can apply at anytime, at any age.

Alberta Blue Cross - Blue Assured - Enhanced

Alberta Blue Cross - Blue Assured - Enhanced

Can apply at anytime, at any age.

Alberta Blue Cross - Blue Assured - Enhanced+

Alberta Blue Cross - Blue Assured - Enhanced+

Can apply at anytime, at any age.

Alberta Blue Cross - Blue Assured - Premium

Alberta Blue Cross - Blue Assured - Premium

Can apply at anytime, at any age.

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