Major medical health insurance, also known as a ‘catastrophic’ plan, is a stripped version of the regular health insurance and is highlighted by lower premiums and higher deductibles. Coverage, too, gets trimmed down to just major hospital and medical expenses, after a certain deductible and a possibility of co payments. The out-of-pocket expense is comparatively higher in such plans.
People buying major medical health insurance usually fall in two groups: young singles in their 20s and adults between the ages of 50 and 65 years. Young adults buying such insurance plans are generally self employed and have tighter budgets to stick to. Older adults are concerned about potential financial losses from critical illness.
Major medical health insurance also serves the purpose for people who have not as yet become eligible for Medicare and thus fill a prominent gap of the insurance industry. Even healthy people with lesser income opt for these plans for their sheer economy and coverage against critical illness.
These plans typically cover expenses for surgery, hospital stays, intensive care, diagnostic X-rays and lab tests. However, preexisting ailments are generally not included, such as emphysema, AIDS, heart disease, diabetes, multiple sclerosis and schizophrenia. Also, they may not offer coverage for hormone therapy, infertility treatment, dental, weight loss surgery, vision or cosmetic surgery.
Before one buys major medical health insurance, it is important to study a few factors to make an informed decision. Assess:
The real concern with major medical health insurance is its high out of pocket cost. It is, therefore, advisable mostly for people who are healthy and require coverage for catastrophic conditions.