ANSWERS: 1
  • Major medical insurance is a very good thing to have. The advantage is insurance coverage for expensive medical care and hospitalization. There are variations on plan costs and benefits from company to company but the basic concept is universal.

    Coverage

    Generally, a major medical policy will cover hospital costs, blood, oxygen, prosthetic devices, surgery and physician fees.

    Benefit Limits

    Major medical policies usually have high benefit limits, typically $250,000 to $1,000,000 or more in maximum lifetime benefits.

    Cost Sharing

    The cost-sharing elements that are factored into major medical plans help make the premiums more affordable in comparison to the premiums for base health insurance plans. The cost sharing or coinsurance usually works on an 80/20 basis after deductibles are paid by the insured. The insurance company pays 80 percent of the costs and the insured pays 20 percent of the costs.

    Deductibles

    Deductibles are usually a preset dollar amount per claim or per cause. When all claims are for the medical treatment for one cause or event only one deductible is paid.

    Stop Loss Feature

    Most major medical policies have a stop loss feature that places a limit on how much the insured will have to pay in deductibles and coinsurance. After the stop loss limit has been met, the insurance company pays the rest of the claims.

    Source:

    Financial Web: Major Medical Insurance:

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