Major medical insurance plans include coverage for almost all types of medical care which one needs. An individual may select a single coverage for oneself, or select the two-person or limited family coverage for oneself and his / her spouse or the one dependent child. Family medical coverage is a scheme covering the entire family.
Major medical insurance coverage is usually provided for all the critical areas such as doctor visits, preventative care, diagnostic tests, hospital and extended care, emergency, prescription drugs, home health care etc. Depending on how much one can pay or what one's family health history is, other less common areas of coverage like vision care, care by specialists, mental health care, family planning services, chronic disease care, physical therapy, maternity care, and baby care can be added.
If one has a single coverage, the spouse can be included on the policy by submitting an application within 31 days after the marriage. Coverage for a newborn or adopted child can be effected by applying within 60 days of the birth or adoption. In the case of family coverage, a new born or adopted child is covered automatically. Coverage is effective from the first month following the receipt of the application form. The coverage terminates when one loses the eligibility for the state group health insurance program. Coverage ends for the spouse at the time of divorce and coverage ends for the dependent children at the end of the calendar year in which they turn age 19 or on the date they marry.
Major medical insurance coverage includes managed-care health plans and indemnity health plans. Indemnity health plan focuses on unexpected illnesses and always allows the patient to choose the physician.