Chaz Posted November 1, 2011 Share Posted November 1, 2011 PPACA limits the ability of plans to have annual limits on essential health benefits. Is that calculated on an aggregate basis (so, as long as plan doesn't exceed the annual limit for all essential health benefits, it is okay) or is it applied on a benefit-by benefit basis (so, for instance, a plan can't have a $xxx annual limit on occupational therapy, assuming OT is an essential health benefit)? I haven't seen this discussed anywhere. Link to comment Share on other sites More sharing options...
Chaz Posted November 3, 2011 Author Share Posted November 3, 2011 PPACA limits the ability of plans to have annual limits on essential health benefits. Is that calculated on an aggregate basis (so, as long as plan doesn't exceed the annual limit for all essential health benefits, it is okay) or is it applied on a benefit-by benefit basis (so, for instance, a plan can't have a $xxx annual limit on occupational therapy, assuming OT is an essential health benefit)?I haven't seen this discussed anywhere. Does anyone have any insight on this? Link to comment Share on other sites More sharing options...
Chaz Posted November 10, 2011 Author Share Posted November 10, 2011 Bueller? Bueller? Link to comment Share on other sites More sharing options...
GMK Posted November 10, 2011 Share Posted November 10, 2011 Just an opinion, based on very little research - I think it's no limits on any essential health benefits. So, you can't put a limit OT services that qualify as essential health benefits. I would think that you could put a limit on OT services that do not qualify as essential benefits, if any. (As I said, very little research.) Link to comment Share on other sites More sharing options...
Chaz Posted November 11, 2011 Author Share Posted November 11, 2011 Thanks for the response. That's what I was thinking too but there are SO many plans out there with multiple limits on individual benefits. Link to comment Share on other sites More sharing options...
Recommended Posts
Create an account or sign in to comment
You need to be a member in order to leave a comment
Create an account
Sign up for a new account in our community. It's easy!
Register a new accountSign in
Already have an account? Sign in here.
Sign In Now