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.

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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.

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Example:

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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.

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What to Watch For:

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