Shopping for good health insurance can be confusing. It's tough trying to decide what type of policy offers the best coverage for the price. The insurance industry has its own jargon, and "comprehensive medical insurance" is one such term. To make informed decisions, consumers need to know what this type of health insurance provides.
The word "comprehensive" suggests wide coverage. Comprehensive medical insurance covers a spectrum of services such as X-rays, emergency room visits, lab work and physician visits. Some policies also cover the cost of prescription drugs. Not all comprehensive health insurance policies are the same. For example, one comprehensive policy might cover the cost of preventive care while another doesn't. And costs associated with comprehensive medical insurance vary from policy to policy.
Deductibles and Co-Payments
A comprehensive health insurance policy often requires the person who's insured to pay a deductible or a co-payment, or both. After the person fulfills the deductible or co-pay obligation, the coverage extends to a certain percentage of the expenses. For example, one comprehensive medical insurance policy might pay 100 percent of all charges after the deductible is met, whereas a different policy might pay only 50 percent.
Managed Care Plans
One type of comprehensive health insurance is the managed care plan. With this type of health insurance, participating providers manage the health care of the person who's covered. The three main types of managed care plans involve health maintenance organizations, known as HMOs; preferred-provider organizations, or PPOs; and point-of-service plans, or POSs. Although their specifics vary, the three are considered comprehensive medical insurance because they cover a wide array of services.
Traditional Health Insurance
Traditional health insurance, in which the policyholder chooses physicians and hospitals, is another form of comprehensive health insurance. Traditional plans have a deductible, co-insurance and regular premiums. Covered services vary by policy from provider to provider.
Comprehensive vs. Limited-Benefit Policies
Comparing comprehensive medical insurance with limited-benefit policies shows the extent of a comprehensive plan. Limited-benefit plans are intended to fill any gaps a comprehensive policy may have. For example, one limited-benefit policy might cover only accidents. If the comprehensive plan covered emergencies, that limited-benefit plan would be redundant. With a major illness that requires hospitalization, there can be a big difference. The comprehensive plan might pay hundreds of thousands of dollars in benefits on that claim, but a limited-benefit policy might pay no more than a couple of thousand dollars.
- Council for Affordable Health Insurance: Mini Medical Plans on the Move
- Georgetown University Health Policy Institute: Understanding Private Health Insurance
- HealthCare.gov: Insurance Basics
- Insurance Information Institute: What Are My Health Insurance Choices?
- Ohio Department of Insurance: Guide to Health Insurance
- Tennessee Government: Know Your Options When Comprehensive Health Insurance Isn't Available
- U.S. Bureau of Labor Statistics: Definitions of Health Insurance Terms
- U.S. National Library of Medicine: Managed Care
Vicki A Benge began writing professionally in 1984 as a newspaper reporter. A small-business owner since 1999, Benge has worked as a licensed insurance agent and has more than 20 years experience in income tax preparation for businesses and individuals. Her business and finance articles can be found on the websites of "The Arizona Republic," "Houston Chronicle," The Motley Fool, "San Francisco Chronicle," and Zacks, among others.