Sunday, December 6, 2009

FEE FOR SERVICE PLAN ( INDEMNITY PLAN )

In my previous post, I gave brief introduction to the different types of insurance plans available around the globe and today's blog entry, will throw ample light upon the facts related to FEE FOR SERVICE health insurance plan, also known as indemnity plan.

In Fee for service plan,you select doctors, hospitals of your choice,and the insurance company pays for up to 80 percent of the cost.but now the question is who pays the other 20%? ? ? YOU DO. yes...It's you who'll pay rest of the amount out of your own pocket and this is what you pay:-

  • PREMIUM:- monthly fee you pay to own the policy.

  • DEDUCTIBLE:This is the amount you'll pay yearly before your company starts paying for your medical services.As a rule, the higher the deductible, the lower the premiums.

  • COINSURANCE: It is generally a percentage of the bill that you are required to pay.For say, if you have a 80/20 plan you pay 20%(coinsurance) after paying the deductible and the insurance company pays 80% after you meet the deductible + coinsurance.

  • COPAY:amount that you are responsible to pay at each doctor visit or purchase prescription drug.

Most people who use indemnity plans enjoy the seamless coverage that give them the green light to choose any provider without checking for network membership.But be aware that the level of coverage may vary from insurer to insurer and the cost of your plan largely depends on the level of coverage you get.

Three types of coverage provided by Indemnity Plans are:

  • Basic Health Coverage-covers the costs of a hospital room,hospital services and supplies, for example x-rays, prescribed medicine, etc. Basic Indemnity coverage also pays toward the cost of surgery and for some doctor visits.

  • Major Medical Coverage-takes over where your basic coverage leaves off. It covers the cost of long, high-cost illnesses or injuries.

  • Comprehensive Coverage -combines basic and major medical coverage into one plan.You should check your health insurance policy to make sure you have both kinds of protection to be on the safe side.


So if you want the flexibility to pick your own doctor, specialists, hospital and if freedom of choice is more important to you than cost,then this type of plan can satisfy that, but be ready to pay for service up front and then have to do the legwork of submitting claim papers yourself in most cases.After all,


"Your life is the sum result of all the choices you make, both consciously and unconsciously. If you can control the process of choosing, you can take control of all aspects of your life. You can find the freedom that comes from being in charge of yourself"

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