Table of Contents
B
Nevada Insurance Enrollment logo - Nevada State outline divided into four colors of dark blue, light blue, orange and yellow

What is a Major Medical Health Insurance Plan?

by | Oct 14, 2024 | Health Insurance

Share this post

What Does Major Medical Provide?

A major medical health insurance plan is a comprehensive medical plan that can help you pay for doctor’s visits, hospitalization, and prescription drugs if you should become sick or injured. It also helps you pay for preventative care.

While there’s no set definition of what “major medical insurance” is comprised of, the term is generally used to refer to health insurance plans that were sold after 2014 and follow the minimum essential coverage guidelines and practices outlined in the Affordable Care Act.

Call for FREE Help
(702) 898-0554

↑ click to call ↑

What is a Major Medical Health Insurance Plan?

The Ten Essential Health Benefits

(that every plan must have included)

  • Hospitalization
  • Prescription drugs
  • Laboratory services
  • Emergency services
  • Ambulatory patient services
  • Maternity and newborn care
  • Mental Health and Substance Use Disorder services
  • Pediatric services (including vision and dental care)
  • Rehabilitative and habilitative services and devices
  • Preventative and wellness services, as well as chronic disease management

 

Covered Services

Major medical insurance plans are designed to cover medical services that the average person might need in their lifetime. The health insurance plans that are sold on the health insurance marketplace, as well as all employer plans, are major medical insurance plans and are required to meet the ACA guidelines. Limited benefit plans, like short-term health insurance, are not required to offer the same benefits as major medical insurance and generally should not be considered good options for the long-term.​

Quote and or Enroll

Who Needs Major Medical Insurance?

If you think that because you’re reasonably healthy and lead an active lifestyle that you don’t need insurance, think again; regardless of how healthy you are, your situation could change in an instant. Because the cost of medical care (especially if you find yourself with a serious or chronic condition) can quickly eat away at the most respectable nest eggs, having an insurance policy is a necessity.

 

Employer-Based Plans
vs.
Individual Major Medical Health Insurance Plans

More than half of working Americans acquire their health insurance through their employer. For most, this is an ideal situation, as they can enjoy relatively low premiums that come out of their paychecks automatically. However, many Americans don’t have this option. For example, if you work for a small business that has less than 50 full-time employees, your employer can opt out of offering insurance without facing a tax penalty. In some cases, even if your employer does offer insurance, you may decide that it doesn’t fit your needs.

For those who are unable or uninterested in getting insurance through their employer, individual major medical health insurance plans are available. Talk to your health insurance agent to learn what types of plans are available and get advice on choosing one that will meet your needs.

 

How Getting Married Affects Your Health Insurance

How Getting Married Affects Your Health Insurance

Getting married means lots of conversations about combining everything from last names to bank accounts. While picking a health insurance plan that covers both of you may seem practical, there are cases in which maintaining separate policies makes more sense.

How to Save Money on Prescriptions

How to Save Money on Prescriptions

If you are among the 55 percent of Americans that are taking a prescription drug, you may be concerned about the affordability of medication therapy. Fortunately, there are a couple of things that you can do to ease the financial burden.

Have You Recently Lost Medicaid Health Insurance?

Have You Recently Lost Medicaid Health Insurance?

If you are currently on Medicaid, there are some scenarios in which you may soon be at risk of losing your coverage. Knowing your options can help ensure that you do not have a gap in health insurance coverage.

Health Insurance Quotes

1). By Phone

(702) 898-0554

↑ click to call ↑
2). Online Quote
3). In Person

4260 W. Craig Road #150-A

N. Las Vegas, NV 89032

Major Medical vs Other Types Of Health Insurance Coverage

A serious illness or injury can have a lasting impact on more than just your health; it can take a significant toll on your finances as well. Too many Nevadans spend years saving to pay off a home or to enjoy a comfortable retirement, only to watch their hard-earned savings and future earned income disappear because of a medical emergency. Very few people are wealthy enough to be self-insured; the rest of us rely on major medical health insurance to protect us from financial hardship.

One of the goals of the Affordable Care Act was to do away with skimpy health insurance plans that don’t provide adequate coverage. For example, short term insurance plans, mini medical plans, indemnity plans, etc. have limits, and many have underwriting qualifications to get them. Desperate Nevadans and sometimes income strapped Nevadan’s who are searching for budget-friendly health insurance options may be drawn to these plans because of their low monthly premiums.

 

Know What You Are Buying!

While these plans may look and sound like major medical health insurance, they do not provide the coverage that many customers expect. Sometimes you may speak with agents that sell these products in a deceitful manner, making them sound like they have coverage of an ACA (Obamacare) plan, but they do not offer the full benefits of one.

 

 

By page visits (this month)

#1) Health Insurance Subsidy Chart

#2) Health Insurance

#3) Health Insurance WITH a Subsidy

#4) Insurance Blog

#5) Request a Quote

Alternatives to Health Coverage

There are two main alternatives to major medical health insurance:

1). Fixed Benefit Indemnity Plans

Nevadans with fixed benefit indemnity plans are reimbursed a set sum for medical services. Despite the skinny coverage, these plans can cost as much as a major medical health insurance plan. In most cases, reimbursed sums are too low, potentially leaving customers who experience major health problems with medical bills sending them into bankruptcy. For example, a popular fixed benefit indemnity plan that costs $450 per month pays $100 for up to five doctor’s visits per year, $50 per year for screening tests and $1,000 a day for up to 30 days in the hospital. On average, hospital stays costs THOUSANDS per day. In all, the average expense for a hospital stay is over $9,000, and that number soars to almost $23,000 if surgery is performed. Fixed benefit indemnity plans may pay a set dollar amount for costs like surgery, tests, and prescription drugs. They pay their fixed amount, and that’s it.

2). Medical Discount Cards

Another type of health coverage that masquerades as major medical coverage is in the form of medical discount cards. As the name suggests, this type of coverage provides discounts on medical services in exchange for a monthly fee. Unfortunately, in many cases, customers have a hard time finding providers that offer the promised discounts, meaning that their monthly payment went towards nothing more than lining the pockets of those peddling these “plans.”

 

Finding Quality Health Insurance with Nevada Insurance Enrollment

If you’re shopping for health insurance with a tight budget, then you may believe that a cheap, bare-bones plan is your only option. However, for most people, major medical coverage is still within reach. One of our agents can help you find a health insurance plan that provides real protection in the event of an injury or illness, ensuring that if the unexpected happens, your situation won’t be worsened with financial troubles. These plans are all ACA approved and may have Government assistance depending on your household income.

By page visits (this month)

 

#1) Health Insurance Subsidy Chart

#2) Health Insurance

#3) Health Insurance WITH a Subsidy

#4) Insurance Blog Posts

#5) Request a Quote

How Many Hours Can You Safely Drive?

If you are not accustomed to spending hours per day in your car, it can be difficult to determine how quickly you should aim to reach your destination.

Safety Tips For Driving In The Rain

In Las Vegas, roads are particularly slick at the beginning of the storm. That is because they are built without a drainage layer. Dust, oil and grime collect on the surface of the road. When it rains and these mix with water, the dirt settles to the bottom and the oil rises to the top, creating a very slick surface.

Understanding Motorcycle Insurance

If you ride a motorcycle, then you need an insurance policy that protects you and your investment. Understanding what coverage is available and even more importantly, what coverage is legally mandated, can ensure that you enjoy your bike for years to come.

Buying a Used Car From a Private Seller

The vehicle’s history report includes information such as its previous owners, open recalls and damage, accidents, repairs, maintenance history, and odometer readings. If you are buying the vehicle from a dealership, then they will probably provide you with the report if you ask for it.

Pin It on Pinterest