Preparing for your hospital needs is as important as protecting your property or planning your retirement. Health insurance is a safety net for financial risks, and it also provides a safeguard for your family.
Just like how accidents are unpredictable, you should also look at how diseases and viruses can be unexpected. These microorganisms are mostly undetected, so no one is ever safe from catching one.
However, it can be prevented if you know how and where to look for the proper protection. A medical policy will not only help you overcome health problems, but it will also save you some money.
For more information on comprehensive health care, check the link below:
Major Medical Health Insurance
Comprehensive health care insurance is a medical policy that has broad coverage for extensive medical services. It covers doctor visits, emergencies, hospitalization, X-rays, and even laboratory work.
It is widely known as major medical health insurance. But, in general, people refer to it as the “real” health insurance in layman’s terms.
Major medical health insurances pay for at least 60% or higher of your expected medical care costs. Also, this type of plan meets every minimum essential benefit standard of the Affordable Care Act (ACA).
However, not all insurance plans that fall into this category can cover the cost of preventive care or prescription drugs. So, again, the cost of every comprehensive health care varies from policy to policy.
Also, this insurance is a “guaranteed issue,” meaning you cannot be denied coverage based on your health, age, status, or gender.
Benefits and Drawbacks of Comprehensive Health Care
Comprehensive health care is an appealing policy because of its long-term benefits. Still, there are also certain drawbacks to understand. Although it covers the most needed medical services related to having a serious illness, these plans cost more in monthly premiums.
In summary, here are the pros and cons of major medical health insurance:
Pros
- Preventive health care coverage (as mandated by the ACA)
- Emergency inclusion
- No lifetime limits
- No tax for HSAs (health savings account)
Cons
- Coverage is limited
- High out-of-pocket costs
- Large deductibles
- HSA pairing (may not qualify)
The cost of premiums is reduced if you get it from the open or special enrollment period. You are allowed on a special enrollment if you have a qualifying event that includes the following:
- Getting Married or Divorced
- Expecting a Child
- Getting a New Job
Comprehensive Health Care
Medical and hospital bills are becoming more expensive as time goes on and as technology progresses. Therefore, it is crucial to secure health care insurance early on for self-preservation.
Many households and individuals choose a major medical policy for assurance that all their medical expenses will be covered. But, some benefits that are still not included are dental and vision care.
Limited benefits plans, fixed indemnity plans, accident supplements, or critical illness plans are excluded. The reason is they are not regulated under the Affordable Care Act (ACA).
Also, some states make health insurance a requirement for their respective citizens for security purposes. Comprehensive health care benefits can be delivered through the following ways listed below:
- Exclusive Provider Organization (EPO) Plans
- Preferred Provider Organization (PPO) Plans
- Health Maintenance Organization (HMO) Plans
- Point of Service (POS) Plans
Coverage
Since the passing of the Affordable Care Act (ACA), these 10 essential health benefits are now covered in major medical health care:
| 1. Ambulatory Patient Services | 6. Laboratory Service |
| 2. Emergency Services | 7. Preventive Care |
| 3. Hospitalizations | 8. Mental Health and Substance Abuse Treatment |
| 4. Maternity and Newborn | 9. Pediatric Care |
| 5. Prescription Drugs | 10. Rehab Treatment |
Again, all health care insurance policies must cover the above medical needs to be considered compliant.
The Affordable Care Act (ACA) made it achievable to include immunizations and preventive care for medical insurance agencies. But, these policies are separate, they can only be purchased through private health care markets.
When you get a major medical health plan, you are eligible to have a health savings account (HSA). This advantage can help you pay for expenses that are not covered in your comprehensive policy.
Cost
Several factors can affect the price of your chosen health coverage. For major medical health insurance, you have to check the plan premiums.
You qualify for premium subsidies if you buy the coverage from your state in the health insurance exchange. It will offset the price of the major medical coverage you intend to buy.
Here is an average cost of your comprehensive health care plans:
Premiums:
- $456/month for individual coverage
- $1,152/month for family coverage
Deductibles:
- $4,364/year for individual coverage
- $8,439/year for family coverage
You can also purchase your insurance from the Health Insurance Marketplace created by the Affordable Care Act (ACA). It is a platform created to put forward its mandate that all individuals must have health insurance.
There are four metal categories of plans offered in the marketplace: bronze, silver, gold, and platinum. You will pay a different percentage of your total yearly costs of healthcare for each plan category.
Then, the remaining amount will be paid by your insurance agency. Below is a table of how you and your plan share costs:
| Plan Category | What Your Insurance Company Pays | What You Pay |
| Bronze | 60% | 40% |
| Silver | 70% | 30% |
| Gold | 80% | 20% |
| Platinum | 90% | 10% |
Alternatives
If you think that a major medical health plan is not right for you, a better substitute would be catastrophic health insurance. This health coverage provides minimal coverage with low monthly premiums.
Catastrophic plans will pay after you reach a high deductible but will cover care visits and preventive care for free. This policy is available to people under 30 years old.
Another one is the qualified health plan (QHP) that also meets certain requirements under the Affordable Care Act (ACA). It is a medical policy usually for people who want to use a government subsidy as a form of payment.
Programs to Get Comprehensive Health Care
You can get major medical insurance through your employer, from the government, or a trusted insurance agency. Since the three require minimum health coverage, it can be considered comprehensive health care.
Tips on Buying a Comprehensive Health Care
Your best choice is to always seek professional advice from a reputable insurance agent or company. After all, most insurance providers create a policy that ensures all medical needs of the insured person are met.
But, if you do not have the time to go out, buying any kind of insurance is now accessible online. However, in case you want to do your own shopping, here are some tips to keep in mind:
1. Check Your Budget
It is important to know your financial capabilities when purchasing health insurance. You also need to determine the type of coverage (individual or family) you want that would fit your budget.
2. Examine Your Medical Needs
If you think you need more than the standard medical services covered, you need to assess your health condition. These details are needed when you apply for major medical health insurance.
3. Always Compare Plans
After looking at all health care plans available to you, compare each policy to really see which is perfect. Take into account what it will cost you yearly, and not just the monthly premiums.
4. Health Savings Account (HSA)
Take advantage of an HSA if you are eligible to have one. You can use it to pay other medical costs.
5. Evaluate Their Network
Some insurance providers have a specific network of medical professionals that you can only get health care from. You may check if your attending physician is part of it before buying coverage.
6. Plan Your Purchase
Enroll on time so that you avoid paying a tax obligation and you get insured right away. Note the schedule of the open enrollment and do not miss the deadline.
Final Thoughts
A comprehensive health care insurance ensures that each person with medical insurance will get the essential medical services available. It also ensures that any individual that wants health insurance can get one regardless of health, age, gender, or status.
Having a major medical health policy can pay for unexpected costly hospitalizations, making it a great option for many. In addition, this type of plan can save you from financial ruin.
Consider your paying capability and medical needs before you decide to get a comprehensive health policy. Also, remember that the cost of individual coverage is different from the family one.
If you find this piece informative, read these other articles for added knowledge on health insurance:
- All You Need to Know About “Medicare for All” 2021
- Is It Illegal To Not Have Health Insurance? State Requirements And Penalties
- Guide To Medical Insurance Deductible, Copays, and Coinsurance
You may share this with your family and friends to inform them of the best health plans out there. Comment down below and share your thoughts about what is comprehensive health care.
