Is Major Medical Coverage Right for You?

Catastrophic health insurance, also known as “major medical” benefits are designed to save you from debt if you ever have a serious medical issue requiring hospitalization or emergency room treatment.  However, this form of care does not pay for regular well-visits (or even sick visits) to a doctor or specialist, nor does it cover prescription drugs or pregnancy and childbirth.  While it may seem as though the major health issues are the only ones that really end up costing you, it is important to realize that these types of benefits are not ideal for everyone.

The Benefits

Major medical insurance has high deductibles and low premiums, making it the single most affordable type of coverage to carry.  Designed to be used only in an emergency or serious illness, insurance companies are able to offer very low prices to people who are young and in good health with low risk of serious physical injury or disease.

From a monetary perspective, the expenses from a major medical event are the ones that will ruin a family or individual's financial security.  Though doctor's visits can be expensive over time, it's the hospital stays, x-rays, diagnostic testing, and lab tests that quickly add up when someone is critically injured or acutely ill.  Those expenses can take a middle class family with a secure future into bankruptcy in what feels like an instant.  

If you cannot afford a traditional HMO or PPO plan, then having insurance that will protect you in the event of a serious problem is the next best thing.

Evaluating Your Choice

Whether or not catastrophic medical coverage is right for you depends on a number of factors.  

If you have a pre-existing condition like heart disease, pregnancy, AIDs or HIV, diabetes, or emphysema, you will not be eligible for this sort of plan.  You should also try to avoid one if you consistently take prescription drugs, as they can become quite expensive without a good health plan.  

Young adults, and healthy people in their 50s and 60s are usually the best candidates for catastrophic insurance.  Retired people who are waiting for medicare benefits to begin can also take advantage of this sort of thing for a few years, as can young men and women who are self-employed or not eligible for coverage through their employers for some reason.   

If you are healthy, and able to afford check-ups, doctor's appointments, and any necessary prescriptions should you become ill with a minor condition – and if you an afford the deductible you will have to pay in the event of a major medical problem – then catastrophic coverage might be the right choice for you. By the same token, if you are frequently ill, reliant on a prescription drug, or unable to pay a high deductible, you should not take a risk on this coverage.  You would be better off to seek out a cheap HMO or PPO.  

To find out exactly what major medical policies are available, and how much they cost, request a free quote from us, and one of our agents will get back to you with the details so that you can make an informed decision.