There is a feature which is commonly found in health insurance policies that limit the amount that will be paid for certain specified expenses, even if the claim does not exceed overall policy limit. What is that feature?
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The feature commonly found in health insurance policies that limits the amount that will be paid for certain specified expenses, even if the claim does not exceed the overall policy limit, is called internal limits.
Internal limits are restrictions on coverage within a health insurance policy that limit the amount that the insurer will pay for certain services or expenses. These limits are typically applied to specific types of medical expenses, such as prescription drugs, hospital stays, or outpatient visits, and are designed to control costs for the insurer while still providing some level of coverage for the policyholder.
Internal limits are different from external limits, which are restrictions on coverage that are set by outside organizations or regulations. For example, a state insurance regulator might set external limits on the amount that insurers can charge for certain types of coverage, or on the total amount of benefits that can be paid out in a given year.
Credit limits and insurance limits are not typically associated with health insurance policies. Credit limits are limits set by lenders on the amount of credit that can be extended to a borrower, while insurance limits are the maximum amount of coverage that an insurance policy will provide for a particular type of loss or damage.