Annual Maximum Per Injury or illness

What is Annual Maximum Per Injury or illness?

Annual Maximum Per Injury or illness is (or Annual Per Injury/illness Maximum). Some health plans limit the total benefit amount they will pay for each injury orillness during the plan year. For example, if you break an arm, your plan will payonly up to $20,000 for all care related to that injury if the plan has a $20,000 benefit limit for each injury. The plan will continue to pay benefits for other conditions but only up to the ‘per injury or illness maximum’ for that plan year. Ifyour plan has a ‘per injury or illness’ annual limit or maximum, it should be statedon your benefit summary or in your benefit booklet.

 

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