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It’s important for every adult living in the United States to know what major medical insurance consists of, what its coverage strictly provides, and how it can be vastly different from other types of insurance you may have seen. HealthMarkets easily breaks down this information so you can make informed decisions regarding your healthcare plan.

What is major medical insurance?

Major medical insurance is a health insurance plan offered to help cover the medical costs an average American will pay in a given year. Major medical insurance is sold by various insurance companies through private or public health insurance marketplaces.

What is major medical coverage?

Major medical coverage is the set of benefits an individual gets when they purchase a major medical insurance plan. Individuals can find specific major medical coverage details listed in a plan’s Summary of Benefits and Coverage. This information can vary depending on the health plan and the insurance company that you select. You can also call your health insurance company or visit their website for more information about your exact plan.

What does major medical insurance cover?

Major medical insurance coverage varies by the type of health plan that you’ve purchased. Short-term major medical insurance is designed to provide coverage until you can find a long-term solution. For example, you may be in-between jobs, or you missed the Open Enrollment Period. This type of plan does not cover pre-existing conditions, and generally only covers certain services.

Affordable Care Care (ACA)-compliant major medical insurance covers 10 essential healthcare benefits. These benefits include a number of different services, such as: 

  1. Prescription drugs
  2. Pediatric services
  3. Preventive and wellness services and chronic disease management
  4. Emergency services
  5. Hospitalization
  6. Mental health and addiction services
  7. Pregnancy, maternity, and newborn care
  8. Ambulatory patient services
  9. Laboratory services
  10. Rehabilitative and habilitative services and devices

Who needs major medical insurance?

Everyone needs major medical insurance. You know the drill—you wake up with a stuffy nose, and eventually it turns into something worse. You decide to visit the doctor for treatment, which can be an unplanned expense. Major medical insurance helps many Americans cover the costs of these doctor visits as well as other medical expenses.

How is major medical insurance different from other forms of insurance?

Major medical insurance differs from other types of insurance in several ways. Short-term plans only provide health coverage for a limited amount of time, generally less than one year.

Major medical insurance likely won’t cover every medical expense you may have. Dental or vision insurance plans are usually purchased on their own. There are also separate policies that can help cover additional costs for accidents, critical illnesses like cancer, and disabilities that require extra financial and medical help

Your material possessions won’t be covered either, and it won’t become more expensive if you have to file a claim, which can occur with car insurance or property insurance.

HealthMarkets can help

HealthMarkets can explain different major medical insurance plans and help you choose one that’s right for your unique needs and budget. Call a licensed insurance agent today at (800) 360-1402 to learn more. Or, if you’re ready to get started comparing major medical insurance plans at this very moment, HealthMarkets can help you review your options online at no cost to you.


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