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Family Health Insurance Caps

Health Insurance Companies Pressured to Boost Coverage
July 2008


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While most of us are aware of the many risks associated with the uninsured, it's only in the last year that the dangers of being an under-insured person are getting attention in the media, and creating a lot of pressure for health insurance companies that don't offer the best coverage at an affordable rate.

One piece of evidence is the little known rule of insurance caps, which have recently proven to have a major impact on family health insurance coverage. It turns out that many health insurance companies place a lifetime cap on their insurance policies, and these caps can be as low as one million dollars.

Sure, one million dollars sounds like a lot; but in today's world of high-priced medical care, parents with a very sick child can quickly discover that their family health insurance plan doesn't cover all of the treatments they need.

California's Daily Bulletin reports the story of a 20-month old child who went through a one million dollar family health insurance cap in less than a month; the child was diagnosed with a dangerous heart condition that would require a transplant.

Other terrible stories include sick individuals whose insurance coverage ran out before they could have the treatments they needed to save their lives.

Several patient advocacy groups have been campaigning to force health insurance companies to raise the caps, or get rid of them altogether. Congress has also been considering two bills that would accomplish the same thing.

But health insurance companies are arguing that keeping these caps allows them to offer family health insurance - and other types of coverage - at lower rates, and with more variety in their plans.

Facts on:

Family Health Insurance Caps

Did you know...
22% of insurance plans have lifetime caps of less than $2 million dollars?
They argue that the real problem lies with overpriced medical care, and doctors who charge too much for their services.

Regardless, by capping insurance coverage too many people, who have paid their premiums all along, are finding themselves without any insurance when they need it more than ever. When consumers go shopping for any type of insurance coverage, it would be wise to ask an agent if there are lifetime caps on their coverage, and it's best to avoid policies with caps that are lower than two million dollars.



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