Understanding A Traditional Indemnity Health Insurance Plan
Health Care Insurance Types - Fee For Service Plans
With continually rising medical costs and health insurance premiums traditional indemnity health insurance plans are no longer the popular choice which they once were, but they do nevertheless still provide a valuable option for many people.
The great advantage of indemnity health insurance plans lies in the freedom which they give to the plan holder to select the care which he requires, where and when he requires it. This advantage however comes at a price.
Once you have received the necessary medical treatment the provider’s bill will have to be paid and, in most cases, this means that, in the first instant, the plan holder will be required to pay the bill. The bill is then sent to the insurance company who will check to see that the treatment is covered by the plan and check the bill against its own list of "customary and reasonable" charges for the treatment in question. Providing the bill is considered to be reasonable the insurance company will then reimburse the policyholder, normally paying about 80% of the bill, or whatever proportion is specified in the plan.
Under an indemnity health insurance plan the plan holder can undergo treatment wherever he wishes and, if he chooses to do so, he can elect to be treated by a leading specialist who would normally charge well above the average price for the treatment being given. If this happens, the insurance company will merely pay that part of the bill which it considers to be reasonable for the form of treatment in question, with the plan holder being required to meet the balance of the bill.
As well as paying a proportion of each bill, individuals who select indemnity health insurance plans are also required to pay a monthly (or occasionally quarterly or annual) premium and an annual deductible, which represents a sum of money to be paid by the policyholder every year towards the cost of medical treatment before the insurance company will begin to meet the cost of medical bills. Despite the fact that these costs can be high, this form of health insurance suits many people.
Categorically needy individuals: Enrollees in Medicaid programs who meet traditional Medicaid age and income requirements.
Health Care Quality Improvement Act (HCQIA): A federal act which exempts hospitals, group practices, and HMOs from certain antitrust provisions as they apply to credentialing and peer review so long as these entities adhere to due process standards that are outlined in the Act.
Purchasing alliances: Locally based, privately operated organizations that offer affordable group health coverage to businesses with fewer than 100 employees. Also known as purchasing pools, health insurance purchasing co-ops (HPCs), employer purchasing coalitions, or purchasing coalitions.
Structure measures: health care quality indicators related to the nature and quality of the resources that a managed care organization has available for patient care.
Three FICCI working groups reports to sustain growth of health insurance sect...
29 Jul 2010 at 8:42am
Orissadiary.com
Three FICCI working groups reports to sustain growth of health insurance sector
Orissadiary.com
New Delhi: India's health insurance sector is set to receive a shot in the arm with the identification and development by FICCI of a possi...
Teachers, schools reach contract agreement - Martha's Vineyard Times
28 Jul 2010 at 3:07pm
Teachers, schools reach contract agreement
Martha's Vineyard Times
Regarding healthcare insurance, teachers agreed to give up the option of a Master Health/Master Medical (indemnity) plan in the second year of their ...
and more »
Agriculture Department Documents and Publications - Insurance News Net (press...
29 Jul 2010 at 11:44am
Agriculture Department Documents and Publications
Insurance News Net (press release)
SUMMARY: The Federal Crop Insurance Corporation (FCIC) finalizes amendments to the Common Crop Insurance Regulations, Stonefruit Crop Insurance Provisions, ...
Feder...
HealthPlan Services Partners With Freelancers Union to Provide Business ... -...
26 Jul 2010 at 9:30am
HealthPlan Services Partners With Freelancers Union to Provide Business ...
PR Newswire (press release)
Freelancers Union uses the market power of a large group to provide members with needed services such as health insurance, retirement planning, e...
|
