Changing jobs, changing plans — what happens to benefit limits

When changing employers in the United States, do your medical insurance limits reset?

Starting Over

Dear Starting Over,

Assuming that your new employer’s plan meets the Affordable Care Act standards, then there are no limits that would need to be re-set.  This is because health reform does not allow annual or lifetime benefit limits.  All plans have unlimited lifetime benefits.  

There is a slim possibility that your new plan is “grandfathered”.  This means that the plan has not made certain kinds of changes since 2010.  Very few of these plans are still around.  If you are in a grandfathered plan, you may have annual and/or lifetime benefit limits.  However, I’m not aware  of any way that your new (grandfathered) plan could count your previous plan’s payments against your new plan’s benefit limits.  So, in effect, you would have a fresh start on the new plan’s limits.  

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Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.