Annual limit

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What is an annual limit?

An annual limit is maximum limit (also known as cap) on the benefits a health insurance company will pay to a beneficiary in a year while they are enrolled in a particular health insurance plan.

These caps are sometimes placed on particular services, such as prescriptions or hospitalizations.

Annual limits may be placed on the dollar amount of covered services or on the number of visits that will be covered for a particular service. After an annual limit is reached, the beneficiary must pay all further associated health care costs for the remainder of the year.