13.3 Major Medical Expense Plans
Major Medical plans, when not used to supplement first dollar plans, are called Comprehensive Major Medical or, simply, Major Medical. This is a very broad, complete coverage plan and is available for both individual and group plans. The services and supplies covered must be performed or prescribed by a licensed physician.
In contrast to basic medical expense insurance, major medical policies provide total maximum lifetime benefits to individual insureds from about $250,000 to $1,000,000 or more. It covers a large amount of possible financial expenses including hospital room and board, hospital extras, nursing services in-hospital or at home, blood, oxygen prosthetic devices, surgery, physician's fee, ambulance services, and more. Major medical provides high benefit limits. It can either serve as a comprehensive stand-alone plan or be a supplement to the basic plan. As medical costs rose, the first dollar policy was found inefficient, so supplementary major medical policies were developed.
Comprehensive Major Medical plans provide coverage for all major medical expenses under a single policy, and are not coordinated with basic plans.
Supplementary Major Medical plans can be combined with basic plans to pick up expenses where the basic plan leaves off to cover expenses that otherwise would not be included at all.
