Health Insurance - Medical Dictionary

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Major Medical Insurance




Major medical insurance is different than health insurance in that a major medical insurance policy is designed only to cover expenses incurred as the result of a serious illness or injury that requires hospitalization. Major medical insurance is often the only coverage an individual might have and is best suited for individual, rather than family needs. However, if you have no other health insurance, major medical insurance is the only way to protect against enormous medical bills incurred from a surgery, illness, or other unexpected medical event.

Major medical insurance policies generally provide a maximum amount of money after a deductible is met. For example, a single hospital stay can result in bills upwards of tens of thousands of dollars and more. A major medical insurance policy pays those bills after the policy deductible is met. So if your deductible was $5000 and your bill was four times that, all you pay is the $5000. Major medical insurance policies also commonly carry provisions to include long-term care and rehabilitation.

Major medical insurance policies do not provide coverage for routine doctor’s visits, diagnostic testing, preventative health care or screenings, prescription drug coverage, or laboratory tests. Essentially, major medical insurance is designed to protect the insured from major medical events and emergencies that result in astronomically expensive treatments. Routine care is excluded and therefore, families with children should seek additional health insurance. However, a major medical insurance policy may be less expensive to purchase than traditional health insurance and may even be necessary in addition to health insurance.

If your health insurance provides limited coverage or limited lifetime benefits, it may be necessary to supplement the policy with major medical insurance. Supplemental major medical insurance would take over after the benefits from an existing health insurance policy were exhausted. If you are concerned about not having enough medical coverage, you should consult your insurance agent to review your current coverage and explore the possibilities of adding supplemental major medical insurance. This can become increasingly important with age as well as changes in financial position.

It might be possible to purchase major medical insurance through your current health insurance provider or your employer. It would be beneficial to check with both your plan administrator and your insurance agent to learn what coverage is available to you from different avenues. If you have good health insurance, you may not need major medical insurance or you might need just a very basic policy. Consider all aspects before you buy including current health status, age, and financial situation.


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