Updated at: 09-01-2023 - By: Helen Skeates

Have you ever wondered what a “master policy” is when it comes to medical coverage? By “master policy,” we mean a health insurance contract provided to a single policyholder that is a pooling together of several separate policies. Instead of providing individual policies for each business site, a master policy pools together all of the relevant health insurance plans. One can utilize a blanket policy for many different scenarios.

For instance, a master policy might be purchased by the business owner or operator to cover the cost of health insurance for all of the firm’s employees. A master policy may also be used to provide coverage for subcontractors, subsidiaries, or any other party which the insured agreed voluntarily to ensure. So, what is master policy in health insurance?

What is health insurance?

The business owner or employer, for instance, might acquire a master policy to cover the medical needs of all their workers. The insured may use a master insurance to extend coverage to voluntary additional insureds like subcontractors, subsidiaries, or even other third parties. Is there a definition for a “master policy” in health insurance?

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Deeper definition

Medical expenses are typically covered by health insurance in full or in large part in exchange for a monthly fee paid to the insurance provider. Even with the most comprehensive coverage, insured individuals still have to pay a portion of their medical bills themselves. These expenditures are primarily made up of copayments and deductibles, which are paid directly to medical providers by the insured prior to receiving treatment.

Private health insurance and public health insurance are the two main types of health coverage available. Health insurance firms offer private plans, which are typically purchased through one’s place of employment. Top private insurance providers in the US include:

  • Health Care Service Corporation of the United States of America
  • Humana
  • Anthem
  • Cigna
  • Blue Cross and Blue Shield
  • Wellpoint

Public insurance, on the other hand, is funded by the government and offered to qualified citizens and their families. Medicaid is a low- or no-cost government health insurance program offered by most states. It’s up to the individual states to choose who is eligible and what services they provide. All U.S. citizens over 65 and those with qualifying disabilities are eligible for Medicare. Individuals typically require additional coverage on top of Medicare because the government program only pays for a percentage of medical costs.

The supply of health insurance in the United States has been significantly transformed over the last decade as a result of the Affordable Care Act (ACA), which was passed by Congress and signed into law by President Barack Obama in 2010. Reforming the medical system, providing health insurance to all uninsured Americans, and reducing health care costs were all goals of the ACA.

The following are some typical phrases used to describe various aspects of health insurance plans:

  • Co-insurance refers to the portion of medical expenses that the insured is responsible for paying, after the deductible has been met. Insurance companies typically pay for the majority of medical expenses when the deductible is met.
  • Physician, other medical practitioner, or medical establishment that treats an insured patient. A patient’s primary care physician coordinates and oversees all of their care, from preventative medicine to emergency care.
  • When a patient has health insurance, they can access the network of doctors and hospitals that have agreed to treat their patients.
  • Preauthorization refers to the process by which a patient must first obtain prior clearance from their health insurance provider before receiving specific medical services, drugs, or devices.

More health insurance-related queries, perhaps? Check out Bankrate’s in-depth health insurance frequently asked questions.

Health insurance example

Generally speaking, there are five major categories of private health insurance policies in the United States.

  • Organization for Maintaining Health (HMO)
  • Organization of Preferred Providers (PPO)
  • Medical Insurance with a High Deductible (HDHP)
  • In-store strategies (POS)
  • Provider-Only Health Insurance Programs (EPO)

Customers can choose from a range of options with these plans. It varies widely from plan to plan, with some allowing patients to see any doctor they like and others restricting them to those in their own restricted network. There is a wide range of premium costs that can be incurred by the insured.

Facts About Master Policy In Health Insurance

Healthcare insurance is a policy given by a company to a person or organization to cover medical expenses. The health insurance premiums can be paid through payroll deduction or paid directly to the insurance company by the person receiving the policy.

Typically, in exchange for a somewhat higher payment, health insurance will cover not only the policyholder but also the policyholder’s spouse and/or any dependent children.

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Common Illnesses Covered By A Health Insurance

The policies vary greatly in terms of the illnesses they cover, so it’s important to do some research before purchasing health insurance. However, the following medical issues are typically covered by health insurance:

Healthcare coverage can be used to pay for the cost of treating any accidental injury. The need for quick hospitalization due to a medical emergency is exemplified by the occurrence of an accident. As a result, a health insurance plan should pay for all of the costs associated with a hospital stay. To be clear, this is subject to the insurance policy’s stipulations.

One other popular feature of health insurance policies is the option for “cashless” payments, which allow policyholders to receive emergency medical care at any hospital in the insurance provider’s network without first having to pay out of pocket.

#2. Cancer

It has been argued that the progress made in medicine has given people new hope. A good example is the possibility of recovery from a potentially fatal disease such as cancer, provided prompt treatment is administered. However, medical expenses can quickly escalate. Fortunately, some cancer treatments may be covered by standard health insurance plans. A policyholder can get complete protection for anything they need, be it surgery, chemotherapy, medicine, or hospitalization.

#3. COVID-19

The fight against coronavirus continues. However, you may protect yourself with the help of health insurance and vaccinations. Coronavirus therapy is covered by many health plans. Masks, gloves, home quarantine costs, medications, hospitalization, and other upgrades are available as optional riders on your insurance policy. If you have adequate insurance, you can protect your loved ones from exposure to the virus.

#4. High BMI, high BP, and diabetes

Treatment for conditions including obesity, diabetes, and hypertension is getting longer. That’s going to put a lot of folks in the red. That’s why many countries offer health insurance as a safety net for families. The coverage will pay for the cost of medical care for conditions that are secondary to or directly caused by the aforementioned disorders.

After a two-year waiting period, anyone with pre-existing diseases including obesity, hypertension, or diabetes will be eligible for coverage.

#5. Heart diseases

Heart is the most vital organ in the body. Therefore, it’s recommended that everyone get theirs tested on a regular basis. Many cardiac-related insurance plans are available. In the case of cardiac issues, this includes both current and previous conditions. The cost of routine medical exams can be defrayed.


There is great relief for many people because health insurance policies can cover treatment for potentially fatal diseases like HIV/AIDS. Any medical care they receive, from an ambulance ride to a stay in a nursing home or adult day care, will be paid for by the insurance policy.

#7. Critical illnesses

Our high alcohol consumption, bad eating habits, work stress, sedentary lifestyle, etc., may put our health at risk for a variety of so-called “lifestyle disorders.” Any of these potentially lethal conditions may not be treated quickly enough without critical illness insurance.

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#8. Specific diseases

Any health insurance coverage will have a 30-day waiting period beginning on the policy’s effective date. However, there will be a 24-month waiting time for conditions like hernia, cataract, ligament repair, joint replacement, spinal issue, gout, and arthritis.

After the policyholder’s waiting time expires, they can file a claim for any of the preexisting conditions that are covered by the policy, as well as any of the acute conditions that are covered immediately.

It’s A Wrap!

What exactly is a health insurance master policy? The short answer is that several policies can be merged into a single one. Keep in mind that the cost of healthcare is steadily rising, making it difficult to obtain necessary medical care without financial assistance. Policyholders of health insurance are fortunate to have access to a wide range of benefits that allow them to maintain a healthy lifestyle and, if ever required, receive care at the best medical facility possible. How about some more reading material?