This refers to the portion of the covered expense, after the deductible is paid, which must be paid by the insured person. Some policies give specific dollar limits on what they will pay for particular services. Make sure that the services you might need have limits that are acceptable to you. Some policies may have limits that are too low for some serious illnesses or injuries as you may end up with large medical bills not being covered by the insurance policy. The amount should be sufficient to cover most conditions.
Some insurance policies limit the amount of time they pay for each illness or injury.
A common benefit period is 52 weeks. After the benefit period is over, the insured must pay the full cost of medical treatment for continuing treatment of the illness, even if the insurance policy remains in effect. The definition used by the insurance company is very important. Most policies will cover pre-existing conditions after a waiting period, which also varies by insurance company. If there has been other insurance coverage in the months prior to obtaining this insurance, the pre-existing condition clause is waived if a certificate of creditable coverage is submitted to the new insurance company from the previous company.