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What is major medical insurance? Looking for health insurance? If you’re like most Americans, you’re looking for a plan that will cover both basic and emergency health needs. You know that protecting your health involves routine preventive care and access to a wider range of services, including the care you’ll need if you get sick or injured.

The kind of health insurance that covers those needs is called major medical insurance. When most people think “health insurance,” they’re thinking of major medical insurance.

Major Medical Insurance and Obamacare

Under the Affordable Care Act—also known as “Obamacare”—most Americans were required to have major medical insurance. Their policies needed to meet a certain minimal requirement, known as “minimum essential coverage.” People whose medical coverage did not meet that criteria were likely required to pay a fine via their federal taxes for every month during which they were not covered. Beginning in 2019, there is no longer a federal penalty for not carrying qualified health insurance. However, some states are beginning to implement their own health insurance mandates and penalties. If you are in a state that has a health insurance mandate and want to avoid a fine, you need to look for major medical insurance.

Most major medical insurance plansincluding plans you’ve purchased privately, purchased through the Obamacare website, or provided via your employermeet the minimum essential coverage requirement. Usually government-sponsored plans like Medicare and Medicaid also qualify.  

What Do Major Medical Insurance Policies Include?

Most major medical insurance policies last twelve months or longer, are renewable, and meet the Affordable Care Act’s minimum essential coverage requirement. They almost always cover these standard healthcare needs:

  • Preventive care, like regular checkups and flu shots
  • Prescription drugs
  • Emergency services, like trips to the hospital after injury or sudden major illness
  • Hospitalization and associated costs, like surgery or anesthesia

Some plans may also include supplementary services:

  • Maternity, newborn and pediatric care
  • Mental health care
  • Treatment for substance abuse
  • Laboratory services
  • Long-term disease management
  • Rehabilitative services
  • Medical devices like wheelchairs

HealthMarkets can help you compare major medical insurance plans from more than 200 national and regional insurance companies. When you’re shopping for major medical insurance, it’s wise to do two things:

  • Talk with a knowledgeable professional about your healthcare needs.
  • Compare and contrast different plans and their benefits.

HealthMarkets allows you to do both. Our thousands of licensed representatives can help you compare plans and find your best fit. Choosing major medical insurance is an important decision. You can trust it to the professionals at HealthMarkets.


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