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It’s important for every adult to know what major medical insurance is, what its coverage provides, and how it’s different from other insurance. HealthMarkets breaks down this information so you can make informed decisions regarding your healthcare.

What Is Major Medical Insurance?

Major medical insurance is a long-term, comprehensive health insurance plan designed to cover a majority percentage of the medical costs an average American will pay in a given year. Major medical insurance is sold by 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 from purchasing a major medical insurance plan. Individuals can find specific major medical coverage details listed in a plan’s Summary of Benefits and Coverage.

What Does Major Medical Insurance Cover?

Major medical insurance covers 10 essential healthcare benefits, including: 

  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! You know the drill—you wake up with a stuffy nose, and eventually it turns into something worse. You decide to visit the doctor, which can cost a bundle. Major medical insurance helps most Americans cover the costs of these doctor visits and other medical expenses. 

How Is Major Medical Insurance Different from Other Forms of Insurance?

Major medical insurance differs from other insurance types because it only covers your most common, essential medical needs. It won’t cover your material possessions, and it won’t become more expensive if you have to file a claim (like with car insurance). 

And by essential, we mean that major medical insurance won’t cover every medical expense you have. For example, dental or vision care often isn’t considered essential, so those kinds of insurance are usually purchased separately. There are also separate policies that can help cover additional costs for accidents, critical illnesses, and disabilities that require extra financial and medical help.

HealthMarkets Is Here to Help

HealthMarkets can explain your different major medical insurance options and help you choose one that fits your needs. Just call one of our thousands of licensed agents today at (800) 360-1402. Or, if you’re ready to get started comparing major medical insurance plans, HealthMarkets can give you health insurance quotes online at no cost to you. 


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