Health Insurance Definitions

Understand Your Health Insurance Options

 

RV Insurance Benefits is often often asked if we offer Major Medical Plans. The answer is absolutely. We also offer other affordable alternatives that may fit your personal needs and budget better. Our agents are trained to provide you a needs analysis that will help you determine what health plan is the best fit for you. 


Does the average consumer of health insurance understand the definition of health insurance insurance terms? Even though consumers hear the terms repeatedly the answer is no. 


If you understand all your options you will be able to maximize your benefits. 


Please read below to learn more about the terms “Major Medical, 

Catastrophic, Short Term, and Indemnity when used to insure your health.


Major Medical. Word Origin. insurance designed to compensate for particularly large medical expenses due to a severe or prolonged illness, usually by paying a high percentage of medical bills above a certain amount. (meaning deductibles and out of pocket maximums) The Affordable Care Act 2020 Out of Pocket Maximum is $8,150.00 per person. 


Major medical health insurance covers all the minimum essential benefits and meets the standards of the Affordable Care Act (ACA) for individual and family coverage.

Major medical health insurance plans are the type of insurance people are referring to when they talk about typical health insurance coverage. These plans comply with the ACA’s regulations for qualifying health plans. They offer the ten essential benefits

  • hospitalization
  • outpatient procedures (also called ambulatory care)
  • preventive care like check ups and immunizations
  • prescription medicine
  • mental health and addiction counseling
  • laboratory services
  • emergency services
  • pediatric services
  • maternity and newborn care


Major medical health insurance covers the most necessary care associated with serious illness and hospitalization, along with plenty of additional benefits.

However, these plans may cost more than other options in monthly premiums due to those hefty benefits. A major medical health insurance plan that is sold during open enrollment or a special enrollment period can qualify for subsidies that significantly reduce the cost of premiums.


The elimination of the health insurance penalty means that more people are consider alternatives to conventional major medical health insurance. One alternative that some people choose is catastrophic health insurance. Catastrophic plans differ from major medical health insurance in that they only offer a very limited range of benefits. These plans will typically cover expenses associated with a hospitalization, surgery or major illness or injury. However, they will not cover preventive care or more minor health issues. The premiums for these plans is far lower than the premium for major medical health insurance to reflect the lower coverage levels.


Short term health insurance was created for to insure for a specific amount of time it allows people to buy coverage that lasts only a couple of months instead of a full year of coverage at a time. Short term health insurance can be a good option if you are moving or suffer job loss. Some states have allowed short term plans to be extended up to three years.


Indemnity Health Plans with a PPO network offer security or protection against a loss or other financial burden. These plans are typically half the cost of a major medical plan and may be a good fit for those who don’t need maternity benefits, and unlimited mental health benefits or a health insurance plan with unlimited policy maximum payouts. These plans offer wellness, doctors visits, imaging and value added benefits such as Telemedicine. They are more the way health insurance was prior to the late 1990’s early 2000.


When deciding between major medical health insurance and other options, it is best to consider your most likely health scenarios, as well as your personal financial situation. Considering the amount of money you have spent on healthcare or would like to save, whether you are likely to need extensive medical care or are you looking to transfer risk to a health insurance company affordably? 


Let us know what is important to you. Our goal is to help you decide what insurance option is going to meet your personal needs. 

  

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