Major Medical Insurance – What happens when you’re faced with a serious medical condition that requires extensive treatment and care? How do you pay for the costly hospital stays, surgeries, and medications?
Major medical insurance is designed to provide comprehensive coverage for these types of expenses, but what exactly does it entail?
In simple terms, major medical insurance is a type of health insurance plan that covers a wide range of medical services, from doctor visits and hospital stays to prescription medications and surgical procedures.
It’s designed to protect individuals and families from the financial burden of unexpected medical bills, providing peace of mind and financial security in the face of uncertainty.
But what makes major medical insurance so important, and how does it differ from other types of health insurance plans?
In this article, we’ll explore the ins and outs of major medical insurance, including its benefits, limitations, and key features.
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What Does Major Medical Insurance Cover?
Major medical insurance offers full protection for a wide range of health services. Under the Affordable Care Act (ACA), all plans sold in the health insurance marketplace must cover 10 essential health benefits.
These include doctor visits, hospital stays, emergency care, pregnancy and childbirth care, mental health services, prescription drugs, lab tests, rehabilitation services, and children’s health care.
Preventive services like vaccines and regular check-ups are also covered. Even though birth control and breastfeeding support are not listed as part of the 10 required benefits, ACA plans must still include them.
Types Of Major Medical Insurance
There are different types of major medical insurance plans you can choose from, depending on your situation:
ACA Marketplace Plans: These are for people who don’t get insurance through work. You can buy them through the federal or state marketplaces. If you qualify based on your income, you may get help paying your monthly premiums.
Employer-Sponsored Insurance: Many people get health insurance through their job. It’s usually cheaper because your employer pays part of the cost. On average, employees pay around $111 each month, and employers cover the rest.
COBRA: If you leave a job that offered health insurance, you can keep your coverage for up to 18–36 months using COBRA. However, you’ll have to pay the full cost yourself, which can be expensive.
Medicaid: This program is for low-income individuals and families. It’s also available to certain groups like children, pregnant women, seniors, and people with disabilities. It often provides free or very low-cost care.
Medicare: Medicare is mainly for people aged 65 and older. It also helps younger individuals with serious illnesses or disabilities.
Student Health Plans: Colleges sometimes offer health insurance for students. But if you’re under 26, you can usually stay on your parents’ plan instead.
How To Get Major Medical Insurance
You can get major medical insurance in several ways. You might get it through your job, through the ACA marketplace, directly from an insurance company, or from government programs like Medicaid or Medicare. If you’re a student, your school might also offer a plan.
Frequently Asked Questions
Do I Need Major Medical Insurance If I Already Have Basic Health Coverage?
It depends. Major medical insurance covers more serious health issues and can protect you from high medical bills, so having it may be a smart choice if you want full protection.
Are There Different Kinds Of Major Medical Plans?
Yes. Some plans have lower monthly costs but higher deductibles, while others cost more upfront but cover more services. Common types include HMOs, PPOs, and high-deductible plans.
How Much Does It Cost?
The price depends on your age, where you live, and the plan you pick. You could pay anywhere from a few hundred to several thousand dollars each year.
Can I Buy It On My Own?
Yes. If you don’t get insurance through work, you can buy a plan through the ACA marketplace, a private insurer, or a licensed broker.
Will I Be Covered If I Have A Pre-Existing Condition?
Yes. The ACA makes it illegal for insurers to deny you coverage or charge you more because of pre-existing health problems.
What Does It Usually Cover?
Most major medical plans cover hospital care, surgery, doctor visits, prescription drugs, specialist care, and medical equipment.
