Major Medical insurance is a form of insurance that covers the costs of medical and surgical expenses incurred by the insured person. It can either be provided by an employer or purchased by an individual. Major medical insurance provides comprehensive coverage for a wide range of medical treatments and services, including surgeries and hospital stays. Many procedures, such as heart transplants, liver and lung transplants. Many complicated surgeries can cost over $100,000, including hospital stays, and major medical insurance will cover most of these costs.

While each plan is different, most major medical insurance plans cover a wide range of medical services and treatments, including:

1. Hospitalization – Major medical insurance plans typically cover hospital stays, including inpatient care, surgery, and other medical procedures.
2. Doctor visits – Major medical insurance plans typically cover visits to your primary care physician, as well as visits to specialists.
3. Prescription drugs – Major medical insurance plans typically cover prescription medications, although there may be restrictions or limitations on certain drugs.
4. Diagnostic tests – Major medical insurance plans typically cover diagnostic tests, such as X-rays, MRIs, and blood tests.
5. Mental health services – Major medical insurance plans typically cover mental health services, including therapy and medication management.
6. Maternity and newborn care – Major medical insurance plans typically cover maternity care, including prenatal visits, labor and delivery, and postpartum care, as well as newborn care.

Rehabilitation services – Major medical insurance plans typically cover rehabilitation services, such as physical therapy, occupational therapy, and speech therapy.

The Average Cost of Major Medical Insurance

The average cost of major medical insurance can vary widely depending on several factors, including your age, location, health status, and the level of coverage you choose. In the United States, for example, the average cost of a single-person major medical insurance plan in 2021 was around $452 per month, while a family plan averaged around $1,152 per month.
However, it’s important to note that these figures are only averages and can vary significantly depending on numerous factors, such as the specific insurance provider, the deductible, and the level of coverage you need. To get a more accurate estimate of the cost of major medical insurance for you or your family, it’s best to shop around and compare plans from several different healthcare providers.

Why Doesn’t My Health Insurance Cover Major Healthcare Expenses?

While it’s true that most health insurance plans do cover some medical expenses, there are some key differences between major medical insurance and other types of health insurance.
One difference is major medical insurance typically has a higher deductible (the amount you have to pay out of pocket before your insurance kicks in) than other types of health insurance. This is because major medical insurance is designed to protect you from large, unexpected medical expenses, like removing a tumor, rather than routine doctor visits and prescriptions.
Another difference is that major medical insurance often has lower monthly premiums (the amount you pay each month to have insurance) than other types of health insurance. This can make it a more affordable option for people who want coverage for major medical expenses but don’t want to pay a high premium every month.
So, why should you consider getting major medical insurance? Well, for one thing, it can provide you with peace of mind knowing that you’re protected in case of a major medical emergency. As stated before, it can be cheaper than a regular health insurance policy. This type of coverage makes sense if you are a healthy adult under 45 who needs protection for major unforeseen health-related events, and any minor issues can be paid for out-of-pocket. If you do end up needing expensive medical treatment, like after a serious car accident, having major medical insurance can help you avoid financial hardship and bankruptcy.

The Pros and Cons of Major Medical Insurance

Like any type of insurance, there are pros and cons to major medical insurance. The pros are it offers relatively cheap healthcare coverage for medical care that can be very expensive, like a bone marrow transplant.
The downside of Major Medical Insurance is it doesn’t cover as many types of medical expenses as other types of health insurance. You may still need to pay for routine doctor visits, like a diabetes check-up, and for prescriptions out of pocket. Also, it’s important to note if you have a chronic medical condition or need ongoing medical treatment, major medical insurance may not be the best option for you.
Another downside of Major medical insurance is it can be expensive for the millions of workers who are self-employed or do not receive insurance through their employers.
Major Medical Insurance can provide you with peace of mind and protect you from financial hardship in case of a medical emergency. However, it’s important to weigh the pros and cons and consider your individual needs before deciding if this type of healthcare coverage is right for you.

Major Medical Insurance Provides Financial Protection

Now that we have a basic understanding of what major medical insurance is, let’s dive a little deeper into the topic.
When it comes to healthcare costs, having major medical insurance can provide a significant level of financial protection that you couldn’t afford on your own. The coverage offered by major medical insurance providers can include expensive hospital stays, complicated surgeries, doctor visits, prescription drugs, and other medical services.
One of the benefits of major medical insurance is that it can provide a level of predictability and stability to healthcare costs. When you have major medical insurance, you know that you will be covered for a wide range of medical expenses, which can help you plan and budget for healthcare costs.
Another benefit of major medical insurance is that it can provide access to a broader range of healthcare services. Without insurance, many people may not be able to afford certain medical treatments or procedures. With major medical insurance, individuals have access to a wider range of healthcare services, which gives them greater peace of mind and helps them maintain and improve their overall health.

Obamacare and Major Medical Insurance

The United States healthcare system, specifically how to improve it and lower costs, has been a topic of heated debate for years. One of the most significant changes in recent history was the Affordable Care Act (ACA), also known as Obamacare.
The core component of the ACA was the implementation of major medical insurance, which aimed to provide affordable coverage to Americans regardless of their medical history. Let’s dig deeper into Obamacare and major medical insurance, including what you need to know about both of them.
Obamacare, officially known as the Patient Protection and Affordable Care Act, was signed into law by President Barack Obama back in 2010. The law aimed to make healthcare more accessible and affordable to Americans, especially those who had previously been unable to obtain insurance due to pre-existing conditions. One of the central components of the ACA was the creation of health insurance marketplaces, which allowed consumers to shop for coverage and compare plans.

How Does Obamacare Impact Major Medical Insurance?

One of the significant changes that the ACA brought about was the requirement that all Americans have health insurance or face a penalty. This individual mandate was designed to encourage healthy individuals to purchase insurance. The overall idea was to balance out the cost of covering those with pre-existing conditions with those who did not.
Obamacare (ACA), has several provisions that impact major medical insurance. Here are a few key ones:

1. Pre-existing conditions: Under Obamacare, health insurance companies can no longer deny coverage or charge higher premiums based on pre-existing conditions. This means that individuals with chronic illnesses or health conditions can access major medical insurance without worrying about being denied coverage or facing high premiums.
2. Essential health benefits: Obamacare requires all major medical insurance plans to cover a set of essential health benefits, including preventive care, mental health services, and prescription drugs. This ensures that individuals have access to comprehensive coverage that meets their healthcare needs.
3. Subsidies: Obamacare provides subsidies to individuals and families with low or moderate incomes to help them afford major medical insurance. These subsidies can lower the cost of monthly premiums and out-of-pocket expenses, making healthcare more affordable for many people.
4. Medicaid expansion: Obamacare expanded Medicaid eligibility to more low-income adults, which increased access to major medical insurance for millions of people.
   Overall, Obamacare has had a significant impact on major medical insurance by making it more accessible and affordable for many Americans.

Obamacare’s Health Insurance Marketplace

Under Obamacare, individuals could obtain coverage through their employer, through a government program such as Medicaid, or through the health insurance marketplace.
The health insurance marketplace was designed to provide a one-stop shop for consumers to compare and purchase insurance plans. The marketplace offered a variety of options, including bronze, silver, gold, and platinum plans. These plans differed in terms of premiums, deductibles, and out-of-pocket expenses, with platinum plans having the highest premiums but the lowest out-of-pocket expenses.
One of the benefits of major medical insurance under Obamacare was that insurance companies were no longer able to deny coverage or charge higher premiums to individuals with pre-existing conditions. This meant that individuals with chronic illnesses or other medical conditions were able to obtain coverage at an affordable rate.

A Few Things To Consider About Major Medical Insurance

If you’re considering purchasing major medical insurance, there are a few things you should keep in mind. First and foremost, it’s important to understand the different types of plans available and the costs associated with each. You should also consider your overall healthcare needs and choose a plan that best fits your budget and coverage needs.
Another factor to consider is the open enrollment period. Under Obamacare, there is an annual period during which individuals can enroll in or switch health insurance plans. This period typically runs from November to December, although some states may have extended periods.
Last, it’s important to understand the potential impact of changes to the ACA. The Trump administration made several attempts to repeal and replace Obamacare, and while these efforts were ultimately unsuccessful, it’s possible that future administrations could make changes to the law that could impact your coverage, including adjustments to Major Medical Insurance coverage.
Overall, major medical insurance under Obamacare has made healthcare more accessible and affordable for millions of Americans. By understanding your options and choosing a plan that fits your needs, you can protect yourself and your family from potentially catastrophic medical expenses. Whether you’re shopping for insurance for the first time or looking to switch plans, it’s important to do your research and choose a plan that provides the coverage you need at a price you can afford. Compare Major Medical Insurance Plans and rates in minutes. Enter your zip code and fill out a free no-obligation quote in about five minutes.

Deciding on a Major Medical Insurance Plan

Let’s face it, Major Medical Insurance plans can be very complex and difficult to understand. It can be challenging to navigate the different types of plans, coverage options, and deductibles. This complexity can make it difficult for individuals to choose the right plan for their needs and budget.
Despite these potential downsides, major medical insurance can be a critical investment in your health and financial well-being. Here are some tips to help you choose the right major medical insurance plan for your needs:

1. Evaluate your healthcare needs: Before choosing a major medical insurance plan, evaluate your healthcare needs. Consider factors such as your age, health status, and any chronic medical conditions. This information can help you choose a plan that provides the coverage you need at a price you can afford.
2. Consider your budget: Major medical insurance can be expensive, especially if you are self-employed, so it is essential to consider your budget when choosing a plan. Evaluate your monthly premium costs, deductibles, and out-of-pocket maximums to determine what you can afford.
3. Research different plans: There are many different types of major medical insurance plans, so it is essential to research your options. Consider factors such as the plan’s coverage options, deductibles, and out-of-pocket maximums.
4. Review providers: When choosing a major medical insurance plan, it is essential to review the network of healthcare providers. Ensure that the plan includes the doctors and hospitals that you prefer to use. This is important as many patients have developed trust, built over years, with their doctors.
5. Consider additional benefits: Some major medical insurance plans offer additional benefits, such as dental and vision coverage. Consider these benefits carefully when choosing a plan.

Major medical insurance can be a critical investment in your health and financial well-being. While there are potential downsides to major medical insurance, such as the cost and complexity of plans, it can provide a level of predictability and stability to healthcare costs.

Choosing a Major Medical Insurance Plan

To choose the right major medical insurance plan, evaluate your healthcare needs, consider your budget, research different plans, review the network of healthcare providers, and consider additional benefits. You should also understand the different types of major medical insurance plans that are available. The three most common types of major medical insurance plans are:

1. Health Maintenance Organization (HMO) – An HMO plan typically has a lower monthly premium but requires you to choose a primary care physician (PCP) who will be your first point of contact for all medical needs. If you need to see a specialist, you will need a referral from your PCP. HMO plans typically have a narrower network of healthcare providers, so it is important to ensure that your preferred doctors and hospitals are in the plan’s network.
2. Preferred Provider Organization (PPO) – A PPO plan typically has a higher monthly premium but provides more flexibility in terms of choosing healthcare providers. With a PPO plan, you do not need a referral to see a specialist, and you can see any provider in the plan’s network without needing to choose a PCP. However, seeing out-of-network providers can result in higher out-of-pocket costs.
3. Point of Service (POS) – A POS plan is a hybrid of an HMO and PPO plan. It requires you to choose a PCP and typically has a narrower network of healthcare providers than a PPO plan. However, like a PPO plan, you can see out-of-network providers for higher out-of-pocket costs.

When choosing a major medical insurance plan, it is important to consider which type of plan best fits your specific healthcare needs and budget. Review the plan’s coverage options for all the medical services and treatments covered. For example, some plans may offer coverage for alternative therapies, while others may not.

The Top 25 health insurance providers in the USA

(overall market share from highest to lowest)

1. United Health
2. Kaiser Foundation
3. Anthem Inc.
4. Centene Corporation
5. Humana
6. CVS Health
7. Health Care Service Corporation (HCSC)
8. CIGNA
9. Molina Healthcare
10. Independence Health Group
11. Guidewell Mutual Holding
12. California Physicians’ Service
13. Highmark Group
14. Blue Cross Blue Shield of California
15. Blue Cross of Michigan
16. Blue Cross Blue Shield of New Jersey
17. Caresource
18. UPMC Health System
19. Blue Cross Blue Shield of North Carolina
20. Carefirst Inc.
21. Metropolitan
22. Health Net of California
23. Local Initiative Health Authority
24. Point32Health
25. Blue Cross Blue Shield of Massachusetts

Major Medical Insurance Deductibles

Another factor to consider when choosing a major medical insurance plan is the deductible. The deductible is the amount you need to pay out-of-pocket before your insurance coverage kicks in.
Plans with higher deductibles typically have lower monthly premiums, while plans with lower deductibles have higher monthly premiums. It is important to consider your healthcare needs and budget when choosing a plan with a deductible that works for you.

This Insurance is  a Life Saver

Major medical insurance can cost less than many health insurance plans and be a life-saver if a major medical event occurs like a heart attack or serious car accident. When considering major medical insurance coverage, it is also important to understand the costs associated with your plan. In addition to the monthly premium, there may be out-of-pocket costs, such as deductibles, copays, and coinsurance to consider. It is important to understand these costs and how they will impact your overall healthcare expenses.
It’s important to review the network of healthcare providers associated with your major medical insurance plan and find the best plan for your budget. Some plans may have a narrow network of providers, while others may have a wider network. It is important to ensure that your preferred doctors and hospitals are in the plan’s network, as seeing out-of-network providers can result in higher out-of-pocket costs.
Major medical insurance coverage can provide critical financial protection and access to healthcare services. With careful consideration and planning, you can choose a major medical insurance plan that provides the coverage you need at a price you can afford.