Margaret Huntley Last Updated On: June 27, 2023

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Understanding Major Medical Insurance Made Easy

Major Medical Insurance

Major medical insurance is the type of medical insurance with the most comprehensive coverage. These policies cover all essential health care laid out by the Affordable Care Act (ACA). 

All major medical insurance policies cover:

  • Hospitalization
  • Outpatient Procedures/Ambulatory Care 
  • Preventative Care (such as check-ups and immunizations)
  • Prescription Medication
  • Mental Health and Addiction Counselling 
  • Laboratory Services 
  • Emergency Services 
  • Paediatric Care 
  • Maternity and New-Born Care 

Other, non-essential healthcare services such as dental and eye care are not included. For those types of services to be covered, you must purchase additional coverage. 

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Benefits of Major Medical Insurance Policies

  • The main benefit of major medical insurance plans is their extensive coverage, making it the perfect plan for the everyday person. 
  • You may not currently be ill or be planning on having a child, but life is unpredictable. Accidents can happen, unforeseen circumstances can arise, and it’s better to be prepared for them in advance so you’re not stuck paying entirely out of pocket for medical bills. 
  • Major medical insurance covers you for pretty much any medical circumstance that may arise in the average person’s life. The peace of mind that comes with that kind of preparedness is the primary benefit of major medical insurance policies. 
  • You should know, however, that due to the wide range of coverage offered by major medical plans, they are on the expensive side. But, unlike other types of insurance policies (such as car insurance) your premiums do not increase after making a claim. So you will not need to worry about that fluctuation.
  • Yet another benefit of major medical insurance is that you might be eligible to purchase a health savings account on your plan. Your Health Savings Account (HSA) is a non-taxable savings account that you are permitted to access in case of an emergency if you are unemployed at the time. Think of your HSA as a financial safety net specifically for health care. 

Purchasing Major Medical Insurance

Major medical insurance is available through both state marketplaces as well as licensed private insurance companies. 

If you wish to purchase major medical insurance on the exchange, meaning that you purchase a plan through your state’s health insurance marketplace, you will need to do so during the open enrollment period. There are a few circumstances that may cause you to miss the open enrollment period, in which case you will be permitted to apply during a special enrolment period. The eligible circumstances are as follows:

  • You changed jobs
  • Your marital status has changed 
  • You had a child 

Buying a major medical healthcare plan off of the exchange is essentially the same, the only difference is that you will be purchasing through a private company that will likely not have the same enrollment periods as the state does.

Regardless of whether you decide to purchase your coverage on or off the exchange, be sure to shop around so that you can secure the best major medical insurance available. 

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Alternatives to Major Medical Insurance

If it doesn’t sound like major medical insurance is the right fit for you, there are some alternatives you can look into:
  • Catastrophic Health Care: These types of plans only cover emergency care. This plan is cheaper than Major Medical Insurance because it covers less situations.
  • Short Term Health Care: The difference between short term health insurance and major medical insurance is that the latter lasts for a shorter period of time. Typically short term health care plans only last for around 12 months, allowing their cost to be less.
  • Health Care Through Work: You may not need to purchase additional health care coverage because your employer provides a healthcare plan for you. Make sure you know exactly what their plan covers, as that will differ between companies and dictate whether you need to purchase additional coverage privately.
  • Government Funded Health Plans: Medicare and Medicaid are two government funded healthcare plans that you may be eligible to apply for. Medicare is for those 65 and up, and Medicaid is for those with a low income. 
At the end of the day, just like how your health is a personal matter, your health care needs are also very personal. Spend time thinking about what your needs are and look into different health care plans. After some consideration, perhaps you will find that major medical insurance is the right plan for you. 

Margaret Huntley Margaret Huntley is a creative writing and philosophy student at Western University. She has been working as a freelance writer for over two years and has written about everything from insurance, to poker, to health and wellness for international businesses.

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