In these traditional fee-for-service group health insurance plans, the patient chooses whichever doctor and hospital he or she wants to use. The plan reimburses the patient for a portion of the expenses paid for the services. (3)
Traditional fee-for-service group health insurance plans. Employees may pay a portion of monthly premium, deductible, coinsurance, and/or copayment. Providers are paid on cost-plus, retroactive reimbursement system.
An insurance policy in which beneficiaries are allowed total freedom to choose their health care providers. Those providers are reimbursed a set fee each time they deliver a service. Reimbursement is usually limited to a percentage of customary and reasonable charges (which may be less than the billed amount). Also see fee for service.
Health care insurance plan in which the person or organization from which you get the health care services is separate from the insurer, who pays the provider or reimburses you for a percentage of expenses after a deductible. These plans provide unlimited choice of doctors and hospitals.
Traditional health insurance plans that pay for all or part of the cost of covered services, regardless of which physician, hospital or other licensed healthcare provider is used. In addition, insured's choose when and where to get their healthcare services. When a claim is filed for covered services, an indemnity plan either reimburses the medical provider or the insured, based on plan provisions. Typically, an insured will have some out-of-pocket costs, including an annual deductible and a co-insurance amount.
group health insurance plans that generally allow the patient to use any covered provider for plan services. Generally, the participant pays the full cost of services until a deductible is met, then the participant and the plan share the costs.
In indemnity plans, the member chooses his or her own providers. Oversight of care by the health plan is minimal. The member's out-of-pocket payments are generally a percentage of the provider's usual and customary fee schedule.
A type of health insurance that pays most doctor and hospital costs. This type of insurance is often more expensive but provides the best coverage and the most choices.
