Major Medical vs Limited Medical Insurance . . . Nationalization . . . Reform . . .

Real Estate Broker/Owner with Schulenburg Realty, Inc. IL License #471.009970

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There is a HUGE difference between Major Medical and Limited Medical Insurance!

Many people that I talk with are pretty happy with the health insurance, Major Medical, plan that they have.  They pay the monthly premium (the hard part) and know that if something major happens, they are covered!  That's security.  They are insured.  That's what insurance is for.  Protection against losing your assets, equity in your home, retirement funds, etc. should you come down with a major illness.

However, there are quite a few that I talk to that are paying unusually LOW premiums for what they believe is a Major Medical Plan.  Once I do a review of what they have I often find that they don't have a solid plan at all.  What they have is a Limited Medical Plan.  They are left WIDE OPEN FOR FINANCIAL DISASTER should something happen to them (ie. cancer, heart attack, stroke).  We all know people that have had major problems.  In fact, 1 out of 3 of us will at some point in our lives come down with a Critical Illness.

It is important to understand the difference between Major Medical and Limited Medical Insurance.

Major Medical

Provides catastrophic coverage and high limits of coverage (typically $1 million annually and $5 million as a Lifetime benefit). Because the cost of major medical has been increasing, insurance companies have provided options, called deductibles, up to as high as $25,000 in some cases.  This very high deductible would certainly be affordable with monthly premiums to the insured, provide protection against a $100,000+ medical bill and be a last resort for those looking for a cheap payment.  Deductibles typically range from $1,500 and higher.

Limited Medical

Provides the guarantee of affordable insurance but limits its coverage to everyday illnesses and accidents. In addition, the maximum benefits paid in each medical situation are capped (limited).  This leaves an insured WIDE OPEN FOR FINANCIAL DISASTER should a major medical issue arise.  Limited Medical is considered "Supplementary" in many cases since it should "come alongside" a persons Major Medical Plan.

If our world were ideal, everyone would have a quality Major Medical Plan.  However, due to pre-existing conditions and sometimes cost-prohibitive monthly premiums, many people are unable to obtain their own policy.

National Health Care Debate

There continues to be much discussion about nationalizing health care.  There may be good reasons for the discussion, but as usual, when the Federal Government gets involved the outcome is less than rosy.  But, to stay on topic and not get political, there are resources today for the uninsured without the need to nationalize health care.

In Illinois there are three major government sponsored health care plans for those who either can't afford it, have a pre-existing condition or are 65 and older.

Check out the websites if you are in a situation as described above.  The sites will give great information should you be in a situation where you can't get your own health insurance.

As always, if you're in Illinois and have questions about your health insurance, real estate or mortgages, give me a call at the number below.



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Tony Dale

Randy,  are you aware the a growing number of the Limited benefit medical plans are now including a Patient Advocacy service from The Karis Group to specifically help their members understand and cope with the out of pocket expenses associated with these plans.  If you do much in this area you will want to look into this.  You are welcome to contact me via my companies website at  Thanks!  tony Dale

Jan 07, 2010 07:07 AM #1
Randy Schulenburg
Schulenburg Realty, Inc. - Algonquin, IL
Schulenburg Realty, Inc.


I am aware of Patient Advocacy services and will certainly review your website.  Do you also work with those who have very high deductibles and thus end up with very high out of pocket medical bills?  My office of 60+ independent health insurance agents come across this more and more as well as those who just can't afford, or don't want to pay for a major medical plan.

Thanks Tony.  I look forward to your response.

Jan 07, 2010 07:28 AM #2
B Henderson

What is being done to provide catastophic coverage for Realtors?  Still nothing after all of these years. 

I don't know if I can continue to risk being self employed.  When it comes to medical expenses, I can afford the little stuff...I cannot shoulder the big stuff.  Example:  My daughter had simple out patient gall bladder removal, the cost $17,000.00.  Trust me this is not the big expenses.  What of the person battling cancer?  Major auto accident?  These are the situations when we need insurance, not the $125 toward an annual check up. 

The insurance industry has only been cherry-picking young and healthy individuals for coverage for years.  Our govt. has been shouldering the heaviest burden through medicare and disability programs etc.  (By the way the Govt is US...the taxpayer!) 

Insurance companies have offered plans that do not serve citizens...

They offer plans that create profits for insurance companies. 

Keep our colleagues who cannot get coverage in your prayers.  Best of Luck Barry.

Sep 19, 2012 07:50 AM #3
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Randy Schulenburg

Schulenburg Realty, Inc.
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