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Major Medical Insurance Catastrophe
Major Medical Insurance Catastrophe
is a special type of fee-for-service plan. They are designed to provide protection against long-term chronic or catastrophic illness or injury. These plans cover a broad area of health care services and are designed to protect against large medical expenses only. Typically included in a major
Major Medical Insurance Catastrophe plan are: the services of private registered nurses, at-home, in-office, and in-hospital medical care, X-ray treatment, prescription drugs and laboratory tests. |
| Supplemental Medical Insurance offers voluntary employee health insurance benefits including
dental, accident, life, cancer, long-term care, and short-term
disability. |
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Instead of covering only certain enumerated expenses,
Major Medical Insurance Catastrophe plans cover all personal medical expenses (with a few exceptions) whether incurring in or out of a hospital
Major Medical Insurance Catastrophe are, therefore, more fair because they reimburse virtually all patients according to the same formula, regardless of the specialties of the attending physician, the location of the treatment, the drug treatment used, or the diagnostic techniques employed. |
Unlike many basic plans,
Major Medical Insurance Catastrophe do not encourage unnecessary or prolonged hospitalization by covering medical service only if it is rendered in a hospital. The maximum amount of benefits payable is much higher under a
Major Medical Insurance Catastrophe than under a basic medical plan, particularly in the areas of physician and surgeon fees.
Partially reimbursing medical expenses has the combined effect of having a deductible and coinsurance in
Major Medical Insurance Catastrophe, and offers three advantages over basic plans that provide full reimbursement: It discourages over-utilization of services and unnecessarily expensive treatment and facilities -- both of which raise costs. It gives plan participants an incentive to police their own medical fees and keep costs down. It eliminates the payment of many small claims; thereby reducing administrative costs and saving money that would otherwise be spent on higher premiums to offset the additional administrative costs.
There are two types of Major Medical Insurance Catastrophe comprehensive plans that coinsure all covered medical expenses exceeding the deductible and supplementary plans that coinsure expenses in excess of the deductible and expenses in excess of those covered by another plan. Both supplementary plans and comprehensive plans place ceilings on the amount of benefits payable for each insured person. Under the Comprehensive plan, or the
Major Medical Insurance Catastrophe plan it provide coverage for the same types of services covered many other plans. Comprehensive plans also include deductibles and co-payment requirements, but may provide first-dollar coverage (full coverage with no deductible) for emergency accident benefits or waive out-of-pocket expenses for certain benefits.
These Major Medical Insurance Catastrophe plans act as a supplement to another health insurance plan. Supplemental major medical plans cover most medically necessary services excluded under basic insurance plans, as well as charges that exceed the primary plan's limits. Covered services typically include inpatient and outpatient hospital care, special nursing care, outpatient prescription drugs, medical appliances, durable medical equipment, and outpatient psychiatric care. Supplemental major medical plans set deductibles, require co-payments, and often limit total benefits.
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| Supplemental Medical Insurance does not cover eye and hearing exams, foot care, immunizations, or physical exams. |
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