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Major Medical

Source: https://upload.wikimedia.org/wikipedia/commons/9/96/Donald_Trump_by_Gage_Skidmore_2.jpg This article examines Trumpcare's impact on the Major medical companies and their marketplace. Major medical is the only option available to individuals and families who fall outside of the Obamacare, Medicare and Medicaid umbrellas.

Major medical is what is what is considered standard medical insurance for individuals. More than half of all Americans get their insurance policies through an employer-provided plan. Most of the remaining population receive medical coverage through Medicare and Medicaid. About 50 million Americans are considered "uninsured" and under the Affordable Care Act are required to enroll in some form of major medical plan. For most Americans, failure to enroll in a medical insurance policy will incur a fine when it comes time to pay taxes.

What is "major medical?"

Individual major medical insurance is an option for individuals and families who do not have access to a health plan through an employer or public program. Individual major medical plans offer comprehensive health insurance coverage and may be purchased from a health insurance carrier, agent or broker.

Individual major medical plans offer benefits similar to those available through an employer-based plan. Consumers pay a monthly premium for access to health care services. They must often meet a selected deductible before benefits kick in, and they will share health care costs with the plan in the form of copayments and/or coinsurance.[1]

What does Obamacare require major medical cover?

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care [2]

How does major medical work?

While major medical plans have considerably higher premiums, they also provide a wider range of service. It includes policy structures like HMOs, PPOs and fee-for-service programs. Major medical insurance is required to cover doctor visits, hospital visits and care performed on an outpatient basis. Rather than have the policy holder pay for services in cash, the major medical system functions with payment thresholds called deductibles. Deductibles are the amount a consumer needs to pay before the insurance company will provide benefits and cost coverage. Typically many services.[3]

What are the breakdown of major medical premium tiers?

There are four tiers of plans under Obamacare

    1. Bronze plan – 60 percent of covered medical expenses paid by the plan; 40 percent by the consumer
    2. Silver plan – 70 percent of covered medical expenses paid by the plan; 30 percent by the consumer
    3. Gold plan – 80 percent of covered medical expenses paid by the plan; 20 percent by the consumer
    4. Platinum plan – 90 percent of covered medical expenses paid by the plan; 10 percent by the consumer

Max Goldberg https://commons.wikimedia.org/wiki/File:Donald_Drumpf.jpgTrump on Major Medical

The platform behind Trumpcare's reform is that competition will lead to better, not worse, care for Americans. While Obamacare is predicted to cause premiums to skyrocket in the next few years[4], Trump argues that a competitive marketplace would put a limit on how high premiums and other costs can go. Furthermore, not all Americans need insurance, especially the young and healthy. Trump submits that the requirement for all individuals to have insurance, or face a fine, is unamerican, despite the ruling of the supreme court with regard to the individual mandate.

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