Health · Chapter 15 · Cost Sharing
Internal (Inside) Limits & Benefit Period
Definition
Caps on specific covered services (semi-private room only, UCR-only, $10,000 rehab lifetime max). Post-ACA, internal/annual limits are allowed only on NON-essential benefits. The benefit period defines when claims count against limits.
Easy to confuse with
These are what this term gets tested against — if you can't tell them apart cold, drill the contrast.
Related terms