Limits and Caps

Well there is a limit, sub limits and combined limits on the services that you need. Lost you are  not on your own. There is no universal definition and its application various from one fund to another. Finder.com.au has an article that explains it as Annual limit is the maximum that you are entitled to, for a particular service in that year. Sub limits may apply to services within the annual limit and is sometimes deducted from and the limit,  combined limit the aggregate various services under one heading and may have its own limit. There is no universal definition

PHI

Limits and Caps

The amount of benefit for a health service is either a set limit or a percentage benefit.

Set Limit has a cap of what will be paid by your insurer for the particular service.

With a percentage benefit a percentage of the cost of the service is covered and the balance is upto you to pay. Some funds allow you to aggregate funds from other services to use for a particular service.

If you do not use the benefit for the year, then you lose out on the benefit for good. An article by Choice magazine1  titled “Less for more” does a fantastic job of explaining this.

  1. https://www.choice.com.au/money/insurance/health/articles/is-your-extras-policy-losing-value
  2. https://www.finder.com.au/health-insurance-annual-benefit-limits

XHP

Limits and Caps

Straight up, there is no limits for any service. How much you spend on a service that you need or which services you choose to use is again your call. Furthermore you may not use all the services in a given year so why lose out. We think you should accumulate your unused funds year on year as you may need the service sometime in the future. How about family members who don't use certain services but need more of other services. It is only fair that you be in control of your health and financial decisions