0

Comments

Major medical insurance is a designed health insurance policy with the specific intention of covering most major medical expenses. Expenses; such as:

• Hospital Care
• Prescriptions
• Surgery
• And so on…

The specific coverage is going to vary considerably and most all insurance companies should very clearly detail out the medical issues that are and are not going to be covered. If they don’t do this you should seek out another carrier so you don’t find yourself with a major medical emergency you think should be covered and then find out otherwise.

You’re going to find that cosmetic surgeries will not be covered as they are an elective surgery and for the most part alternative medical treatments aren’t going to be covered either. Examples of an alternative medical treatment would be massage and acupuncture, etc…

Premium Payment

The insured will pay a premium payment when the major medical insurance policy is written just like with any other type of insurance. The premium payment can be paid, monthly, quarterly or all at once every year dependent on the specific terms of your plan.

Under most health plans; and major medical insurance is no different, you’re going to find that there is a short waiting period before any of the coverage is going to kick in. The reason for the delay is that it is served to prevent those people that only seek out insurance when they think or know some very large medical expenses are on the horizon.

An example would be that of a cancer diagnosis. Anyone that has a preexisting medical condition will likely find that the preexisting condition; whatever it may be, will be explicitly excluded from the major medical insurance policy. If things like this were included into your policy you would be seen as an adverse risk; and for this reason the insurance company will not extend you coverage for these types of problems; such as an epilepsy disorder for one example.

Deductible

After your premium, which is simply the cost of having your policy, you’ll have to meet a deductible amount, determined by your policy, before your insurance will kick in to make any payments.

There are some plans that might pay from $0; however, if you were to purchase such a plan you’re going to be paying substantially higher amounts in premiums and should weight the premium cost versus the deductible when making a decision to go with a policy of that nature.

Copayment

Also just like regular health insurance those with major medical insurance are also going to have copayments or coinsurance. The copayment is a set dollar amount that the insured has to pay every time they seek a service. Coinsurance is where the insurance company is going to pay a percentage and you’re responsible for the other part. One of the most common is on an 80/20 split, the insurance company will pay 80% and you’re responsible for the other 20%. With coinsurance you will usually find that it is a little higher of coverage percentage; such as 90% of prescription and 80% of other. This figure is not an end all be all so you have to make sure what’s in your exact policy and not just take this figure at face value.