Group insurance vs. Major Medical Insurance (plan, hospital, doctor, coverage)

[Pinkmani]

Can someone list the pros and cons of group and insurance, as well as the pros and cons of major medical insurance?

[golfgal]

Are you looking for the differences between a group plan and individual plans?

Group plans typically have more comprehensive coverage with lower out of pocket costs compared to individual plans with a similar premium amount but that does vary depending on what the employer contributes, how old you are and where you live. Do you have specific questions? It's a little hard to answer a question like this in general terms.

[Pinkmani]

Originally Posted by golfgal

Are you looking for the differences between a group plan and individual plans?

Group plans typically have more comprehensive coverage with lower out of pocket costs compared to individual plans with a similar premium amount but that does vary depending on what the employer contributes, how old you are and where you live. Do you have specific questions? It's a little hard to answer a question like this in general terms.

I'm in college, and my assignment is to come up with alternatives to Obamacare or justify why Obamacare shouldn't be repealed.

My idea: Require employers to have a group plan option and encourage healthy individuals to purchase a major medical plan.

I know that the benefits of having a major medical plan is that it will cover the huge expenses. God forbid something happens, and you're left with a huge hospital bill, a major medial plan will cover the majority of it. The downside to that would be that regular doctor visits would have to come out of our own pockets. I'm thinking that there has to be more to it than just that.


And with a group plan, everyone in the company pays into a insurance plan. But that's all I understand.

[Ariadne22]

The ACA removes preexisting conditions from underwriting, removes lifetime caps on payouts, and removes the insurance company's ability to cancel for anything other than they are no longer writing this insurance in that state.

There is no possible way, in the absence of federal or state law mandate, any open-market for-profit/non-profit insurance company in its right mind would offer a plan which didn't underwrite preexisting conditions, cap payouts, and allow them to cancel.

It is pretty simple really. You'll probably have a hard time finding 2500 words to justify overturning Obamacare and allowing the private market to cover only those who cost the insurance companies the least.

Unless, of course, we go back to square one and leave the uninsured as uninsured.

[Robyn55]

Originally Posted by Ariadne22

The ACA removes preexisting conditions from underwriting, removes lifetime caps on payouts, and removes the insurance company's ability to cancel for anything other than they are no longer writing this insurance in that state.

There is no possible way, in the absence of federal or state law mandate, any open-market for-profit/non-profit insurance company in its right mind would offer a plan which didn't underwrite preexisting conditions, cap payouts, and allow them to cancel.

It is pretty simple really. You'll probably have a hard time finding 2500 words to justify overturning Obamacare and allowing the private market to cover only those who cost the insurance companies the least.

Unless, of course, we go back to square one and leave the uninsured as uninsured.

The ACA also subsidizes a lot of "Pauls" by robbing "Peters". If you're a "Paul" - you're thrilled - if you're a "Peter" - somewhat less than thrilled. Right now - the first shocks are coming to middle income and upper middle income folks with individual policies. And some in those income categories with group plans. While Medicare folks are sitting on the sidelines - because they think they're fine - above the fray as it were. I kind of look at it like this:

First they came for the Socialists, and I did not speak out--
Because I was not a Socialist.
Then they came for the Trade Unionists, and I did not speak out--
Because I was not a Trade Unionist.
Then they came for the Jews, and I did not speak out--
Because I was not a Jew.
Then they came for me--and there was no one left to speak for me.

And OP - what is your teacher - a sadist? Trying to require you to absorb thousand and thousands of pages of laws - regulations - history - ideas - etc. about which you apparently know nothing - and deliver a cogent analysis? Seems more like the subject for a doctoral dissertation to me than a college term paper.

The alternative to the ACA is leaving things the way they were. Because the ACA will only make a not so good system worse IMO. It's like that old long complicated Harvard Law School test question about how to save estate taxes. Some student wrote "leave it all to charity" and got an A .

BTW - does your teacher have a political POV best you can perceive? If so - where do you go to school? Robyn

[texdav]

The term major medical came into being for a plan that covers more than just hospitalization.Hospitalization was about the only insurance offered when I was young and it only provide coverage for hosipital treatment. Might want to go to the library OP and read up on history of medical insurance.