Full Health Insurance Coverage For High-Cost Medical Treatment like Hospital Stays, Serious Illness, and Surgery
Major medical health insurance is a private or employer-sponsored health insurance policy for individuals and families that provides long-term financial protection against high-cost illnesses, medical treatment, and injuries, such as hospital stays and surgeries, by covering essential healthcare services through specific delivery networks such as HMO, PPO, EPO, or POS.
Major medical insurance is the kind of health insurance coverage you want in place when the medical bills are BIG, and your health is on the line.
Who: Individuals and families.
What: Comprehensive policy covering essential services (surgeries, hospital stays).
Where: Wherever medical emergencies arise (clinical/hospital settings).
When: Long-term/whenever needed.
Why: To provide financial protection against high costs.
How: From an Absolute Best insurance agent – either from the marketplace or ‘off-exchange’.
These health insurance plans are designed to handle the serious stuff: surgery, hospitalization, emergency care, chronic illnesses, and more. If you’re looking for full health coverage that meets federal standards and provides real financial protection, major medical insurance fits the bill.
These plans are built for stability. All plans sold on the ACA Marketplace are considered major medical insurance and must cover 10 essential health benefits without putting annual or lifetime caps on coverage. That’s a big deal if you’re trying to avoid large out-of-pocket surprises.
At Absolute Best Insurance, we help people throughout South Florida choose major medical health insurance plans that work for their needs and budget.
Our local agents serve communities in Tamarac, Greenacres, Vero Beach, Port St. Lucie, Micco, and Deerfield Beach. We’re here to make sure your coverage is right for you.
What Is Major Medical Health Insurance?
Major medical insurance is a private or employer-sponsored policy for individuals and families that provides long-term financial protection against high-cost illnesses – including chronic diseases like Cancer, Parkinson’s, and Alzheimer’s – by covering essential medical treatments through specific delivery networks like HMO, PPO, EPO, or POS, which determine how patients access doctors and manage their out-of-pocket costs.
You can buy a major med plan directly from an insurance company’s website, such as Blue Cross, Aetna, or UnitedHealthcare or through a broker like Absolute Best Insurance or through Obamacare / the ACA marketplace.
Major med also meets the standards set by the Affordable Care Act (ACA), meaning they must cover essential health benefits and cannot impose lifetime or annual dollar limits on those services. If you buy a plan through the ACA Marketplace, it is by definition a major medical plan.
Major medical health insurance offers broader protection than short-term or limited benefit plans. It’s designed to be your primary coverage, not a backup or supplement. You may purchase it on the marketplace or privately.
Our friendly health insurance agents can help you either way.
Major Medical Health Insurance vs. Other Plans
Here’s how major medical health insurance compares to other common plan types:
- Short-Term Health Plans: These are temporary, often limited, and don’t have to cover essential health benefits. They can deny you based on pre-existing conditions and are not ACA-compliant.
- Accident Insurance – Pays a one-time cash lump sum if you get injured – say a broken leg or broken arm.
- Mini-Med or Limited Benefit Plans: These cap what they pay for specific services and may leave you exposed if you face a serious illness or injury.
- Critical Illness – A type of limited insurance that pays a cash lump sum if you are diagnosed with a major disease like cancer or a heart attack. Aflac is the most famous provider of “Critical Illness” and other “Supplemental” plans.
- Major Medical Plans: These offer full health coverage, meet ACA standards, and protect you from the highest costs. They can be employer-sponsored, ACA Marketplace plans, or purchased directly from insurers.
- Indemnity Plan – a type of supplemental or fee-for-service insurance that provides freedom to choose any medical provider by paying a fixed, predetermined cash amount for specific services or hospital stays directly to the policyholder, rather than covering the full cost of treatment like major medical insurance does. The payment is usually in the form of a ‘coupon’.
If you’re living in Greenacres near Forest Hill Boulevard or around Micco off US-1, access to full care is critical. A major medical policy helps make sure you’re covered wherever you go for care.
What’s Covered Under Full Health Coverage
All major medical insurance plans must include the ACA’s 10 essential health benefits. These are the services every qualified plan has to cover:
- Emergency Services
- Hospitalization
- Prescription Drugs
- Maternity and Newborn Care
- Mental Health and Substance Use Treatment
- Preventive and Wellness Services
- Pediatric Care, Including Dental and Vision
- Outpatient (Ambulatory) Care
- Laboratory Services
- Rehabilitative and Habilitative Services
This is the kind of coverage that matters if you land in St. Lucie Medical Center for surgery or need behavioral health support at Indian River Behavioral Health Center in Vero Beach.
It’s full health coverage that follows you through real-life needs, not just routine doctor visits.
Who Should Consider Major Medical Health Insurance?
If you don’t get health insurance through your employer or are between jobs, you need a dependable option. Major medical insurance is ideal for:
- Freelancers and self-employed workers in Tamarac and Deerfield Beach
- Early retirees living in communities like Lakewood Park or Indian River Shores
- Families in Port St. Lucie and Greenacres who want complete protection year-round
- Anyone with chronic conditions or ongoing medication needs
Even though the enhanced subsidies from the pandemic era expired at the end of 2025, premium tax credits under the ACA are still available for 2026. These credits can help reduce your monthly costs, making major medical health insurance more affordable for individuals and families across Florida.
Why Major Medical is the “Gold Standard”
There are three things Major Medical does that almost no other plan type is allowed to do:
- The “Safety Net” (Out-of-Pocket Maximum): Major Medical plans have a legal cap on how much you can spend in a year. In 2026, for example, the maximum an individual will pay for in-network care is $10,150. Once you hit that, the insurance pays 100% of everything else. Other plans often have no cap, meaning you could owe hundreds of thousands.
- No Lifetime Limits: Major Medical will keep paying for your cancer treatment even if it costs $2 million. Other plan types often “cut you off” after they’ve paid out a certain amount (like $50,000).
- Essential Health Benefits: By law, Major Medical must cover 10 categories, including emergency services, prescription drugs, mental health, and pregnancy. Other plans can choose to skip these entirely.
We Help You Choose the Right Major Medical Plan
Our team of dedicated agents works one-on-one with you, offering personalized support at every step. We’ll show you how to compare plans, use your subsidy eligibility, and choose coverage that actually meets your medical needs.
Whether you’re near Coral Springs Medical Center, the Cleveland Clinic in Vero Beach, or live off Sample Road in Tamarac, our local agents are ready to help. We know the hospitals, the providers, and the health plans available in your area.
| “Choosing the right plan doesn’t need to be complicated. “We walk clients through each option and help them understand what’s covered, what it costs, and how it works.” – Stacy Murphy, Owner of Absolute Best Insurance |
Let’s Make Sure You’re Covered
Get in touch with one of our agents today to talk through your options. We’ll help you compare plans, check eligibility, and make sure you’re getting full health coverage that protects what matters.
“No one plans for a health crisis,” says Stacy Murphy. “But with the right major medical health insurance, you don’t have to panic about the bills.”
Click here or give our team a call for a free, no-obligation quote. We even make house calls!
- Tamarac: (954) 642-2101
- Deerfield Beach: (754) 778-8700
- Greenacres & Vero Beach: (561) 420-0280
- Port St. Lucie: (772) 828-2840
- Sebastian (Micco): (772) 321-0813