Major Medical Insurance is the most important insurance you and your family will ever need. This insurance will provide coverage for most types of medical expenses that may incur. Major Medical covers a much broader range of medical expenses including those incurred while in the hospital and out of the hospital. They generally have higher individual benefits and policy maximum limits. Major Medical Insurance policies are divided into two groups: Comprehensive Major Medical, in which the traditional basic coverages and any other types of medical expense are combined into a single comprehensive policy. The other group is Supplemental Major Medical Insurance, in which coverage begins with a traditional policy that pays first, with the Major Medical policy added to pick up expenses uncovered by the initial basic policy. The insurer usually pays the bulk of this expense 80%, with the insured responsible for the other 20%.
Comprehenisive Major Medical Insurance
This type of insurance will start paying benefits after the deductible is satisfied. In this type of policy the insurance holder must evidence that certain medical expenses have incurred and that they have paid for these expenses out-of pocket to satisfy most deductibles. There are essentially two classes of comprehensive major medical insurance: Those that provide first dollar coverage and those that do not. Policies with first dollar coverage will have a deductible amount of zero and after this deductible is met, the policy will immediately begin pay. The second type is supplemental major medical insurace, in which the insurance will may exspense without meeting a certain deductible first.
Major Medical Insurance Coinsurance
This is for sharing between the insured and the insurer of any covered expenses that exceed the deductible. With this type of insurance there is another important feature, which is that this type of policy will usually cover pre-existing conditions. Most policy do not cover conditions in which you had prior to purchasing your policy. Although there could be a waiting period for up to 12 months.
- Hospital inpatient room and board including intensive and cardiac care
- Hospital medical and surgical supplies
- Physicians diagnostic, medical and surgical services
- Other medical practicianers’ services
- Nursing services including private duty out of the hospital
- Anesthesia and anesthesiologist services
- Outpatient services
- Ambulance services to and from the hospital
- Xrays and other diagnostic and laboratory tests
- Radiological and other types of therapy
- Prescription drugs
- Blood and Blood Plasma
- Oxygen and its administration
- Dental Services resulting from injury to natural teeth
- Convalescent nursing home care
- Home health services
- Initial purchase of prosthetic devices
- Cast, splints ,trusses, braces and crutches
- Rental of durable medical equipment, such as hospital types of beds and wheelchairs
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