October 23, 2018
2 minute read

What should you know about major medical insurance?

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) 827-9990 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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© 2023 HealthMarkets Insurance Agency. All rights reserved.

* Medicare Advantage, Medicare Supplemental Insurance, and Part D options can be explored.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

Attention: This website is operated by HealthMarkets Insurance Agency, Inc. and is not the Health Insurance Marketplace® website. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency nationwide except in MA. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.

This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

48536-HM-0522

© 2023 HealthMarkets Insurance Agency. All rights reserved.

* Medicare Advantage, Medicare Supplemental Insurance, and Part D options can be explored.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

Attention: This website is operated by HealthMarkets Insurance Agency, Inc. and is not the Health Insurance Marketplace® website. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency nationwide except in MA. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.

This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

48536-HM-0522

© 2023 HealthMarkets Insurance Agency. All rights reserved.

* Medicare Advantage, Medicare Supplemental Insurance, and Part D options can be explored.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

Attention: This website is operated by HealthMarkets Insurance Agency, Inc. and is not the Health Insurance Marketplace® website. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency nationwide except in MA. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.

This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

48536-HM-0522