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.
Case management: A process of identifying plan members with special health care needs, developing a health-care strategy that meets those needs, and coordinating and monitoring the care, with the ultimate goal of achieving the optimum health care outcome in an efficient and cost-effective manner. Also known as large case management (LCM).
Exchange: The act of one party giving something of value to another party and receiving something of value in return.
Medical advisory committee: Committee whose purpose is to review general medical management issues brought to it by the medical director.
Underwriting impairments: Factors that tend to increase an individual's risk above that which is normal for his or her age.
Westfield Teachers' Contract Reduces Health Insurance Costs by Almost $1 Mill...
9 Mar 2010 at 11:19pm
Westfield Teachers' Contract Reduces Health Insurance Costs by Almost $1 Million
TheAlternativePress.com
The reduction in health insurance costs includes savings made possible by the elimination of traditional indemnity insurance, an increase in off...
Fortis: Premiums up, name out - Health Insurance and Protection Magazine
10 Mar 2010 at 7:54am
Fortis: Premiums up, name out
Health Insurance and Protection Magazine
Already there are plans to introduce a whole of life product to RIAS, specialists in insurance for the over 50s. Advisers contacted by Health Insurance ...
and more »
WellPoint, parent company of Anthem Blue Cross, and California rates hike and...
6 Mar 2010 at 1:33pm
Examiner.com
WellPoint, parent company of Anthem Blue Cross, and California rates hike and ...
Examiner.com
Health insurance is about risk and risk pools of healthy and unhealthy people. That's the business; to collect premiums as a means of indemnit...
Dave Durenberger: The health care summit? Just do it. - Minneapolis Star Tribune
19 Feb 2010 at 5:49pm
Dave Durenberger: The health care summit? Just do it.
Minneapolis Star Tribune
Third, Republicans argue that consumers armed with individual indemnity insurance, financed by tax-free health savings accounts and tax-subsidized risk ...
and more »
|
