What Does A Major Medical Insurance Policy 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.

Call For FREE Help (702) 898-0554


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.

What Is A Major Medical Health Insurance Plan?

The ten essential health benefits that every plan must have include:

♦ Laboratory services

Emergency services

Prescription drugs

Mental Health and Substance Use Disorder services

♦ Maternity and newborn care

♦ Pediatric services (including vision and dental care)

Rehabilitative and habilitative services and devices

♦ Ambulatory patient services

Preventative and wellness services, as well as chronic disease management

♦ Hospitalization

Major medical insurance plans are designed to cover medical services that the average person could need in their lifetime once their out of pocket maximum has been met.  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.

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 on a dime.  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


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.

Call Us For Assistance

(702) 898-0554

Get a Fast & Free Online Quote

Assistance Through Nevada Insurance Enrollment

Choosing the correct health insurance plan can be confusing. At Nevada Insurance Enrollment, one of our licensed health insurance agents will help you understand your coverage and benefits.

Related Articles:

How To Get The Most Out Of Your Health Insurance Plan

Health Insurance, Vision Insurance or Both?

Health Insurance When Traveling – What You Need to Know

Health Insurance Pre-Existing Conditions Covered On Exchange


Read More: Health Insurance in Las Vegas, Nevada


Call us for assistance

(702) 898-0554


Serving Las Vegas, Henderson, North Las Vegas and the entire state of Nevada

Three Ways to Enroll

1).  Apply by Phone

(702) 898-0554

2).  Apply in Person

(by appointment ONLY)

Please call to make an appointment

3).  Online Quote

Path Image - Insurance is confusing

Search This Website

Enter a search term here

Generic filters
Exact matches only
Search in title
Search in content

Why Go Anywhere Else?

When you can have an experienced and caring professional guide you.
Insurance Quotes | Plans | Coverage
Nevada Insurance Enrollment small logo - Insurance Agency in Las Vegas, Nevada
Read why it’s smart to use an insurance agent