Is there a maximum limit on benefits (lifetime, annual, etc.)?
When the TRICARE cap of $3,000 is met, TRICARE will pay 100% of covered medical expenses. The supplement pays nothing. However, the supplement will pay 100% of covered excess charges over the cap. Additionally, Inpatient treatment for mental, nervous or emotional disorders in excess of 45 days if under age 19, or 30 days if age 19 or older, is limited to 90 days (if approved by TRICARE) in a calendar year. Outpatient benefits for mental, nervous or emotional disorders, drug addiction or alcoholism are limited to a maximum of $500 in a 12 month period.
Related Questions
- If a plan imposes an annual or lifetime limit on specific benefits, are amounts paid by covered individuals after satisfying the deductible treated as out-of-pocket expenses under section 223?
- Does the law limit lifetime or annual caps on individual benefits?
- Is there a maximum limit on benefits (lifetime, annual, etc.)?
