Brigette Courtot, Senior Health Policy Analyst

by Brigette Courtot, Policy Analyst
National Women’s Law Center

This post is part of a weekly series on Women and Health Reform.

Does your health coverage have a lifetime maximum? Is it adequate? (If you’re already stumped, a lifetime benefit maximum or cap is the maximum amount of money an insurer will pay for healthcare services over the course of the insured person’s lifetime.) Granted, most insured Americans probably haven’t thought too much about this issue. But in 2007, 55 percent of people with job-based coverage had a lifetime limit on health benefits, an increase from 2004. Nearly a quarter of all workers had a lifetime benefit limit of $2 million or less. If $2 million seems like a lot of money, consider these eye-opening estimates of lifetime costs for certain illnesses and injuries:

• Coronary Artery Disease (the leading killer of women in the U.S.): over $1 million
• Multiple Sclerosis (which affects twice as many women as men): $2.2 million
• Single Kidney Transplant: $500,000
• Spinal Cord Injury: between $624,000 and $2.8 million
• HIV Care: $618,000
• Autism: over $300,000

Chances are you know someone who has suffered from one of these conditions. Maybe you know a family whose members have battled two or more of them. Throw in several years’ worth of more common medical costs — broken bones, rounds of antibiotics, asthma treatments, hearing aids — and it becomes easy to see how a $2 million limit wouldn’t cut it for families that experience major medical problems. Moreover, if health care costs continue to grow by leaps and bounds while lifetime benefit limits remain at levels set in the 1970s, even those with more minor medical costs could find themselves bumping up against lifetime limits.

by Brigette Courtot, Policy Analyst
National Women’s Law Center

This post is part of a weekly series on Women and Health Reform.

A few weeks ago, I took part in my best friend’s wedding. She was a beautiful bride, and everything went according to plan.  Well, almost everything. 

Several months ago, the bride-to-be left me a voicemail. She was clearly upset. Hundreds of possibilities occurred to me - a major fight over the guest list? Bridesmaid dresses discontinued? I never would have guessed that it had something to do with health coverage. What does health insurance have to do with a wedding?

Here’s the story: my best friend had been working full-time as a teacher’s aide and was covered under her school system’s health plan. But she is studying to be a teacher, and needed to leave the job to fulfill her student teaching requirement. She couldn’t afford her university health plan. She shopped around in the individual insurance market, but the policies were too expensive, or they didn’t cover treatments for the form of arthritis that she was diagnosed with a couple of years ago. She even considered going without any insurance at all, but knew she couldn’t pay out-of-pocket for her arthritis medications and didn’t want to live in constant fear of a catastrophic health event.