Limit on the amount of claims an insurer will pay in a given year for an individual. In 2010, the ACA banned annual dollar limits for most covered health benefits on all employer-based and individual health insurance plans.
Annual visits covered by Medicare to develop a personalized prevention plan that takes a comprehensive approach to improving health and preventing disease.
A requirement — typically a state law — that a managed care organization must accept any properly licensed provider willing to meet the terms of a plan’s contract, whether the organization wants or needs that provider. It is often described by...