The rising cost of health care over the past 25 years— largely
shouldered by business—has driven the problems in the
healthcare system.
Until the early 1980s, most people received health coverage
through a traditional indemnity or fee-for-service plan.
Under this type of plan, your insurance company pays all or
part of the bill for any doctor, hospital or other health care
provider that you may choose.
With traditional insurance, also called indemnity insurance, you are free to
visit the doctor of your choice. You can change to another doctor at any
time for any reason. And you can use any hospital or licensed medical
facility you choose.
Indemnity plans existed before the rise of HMOs, PPOs and
other types of managed care plans. How
ever, indemnity plans—with their focus on flexibility—aren’t
very effective at controlling costs. In the early 1990s,
indemnity plans lost their leading position in the U.S. health
coverage market. Starting in 1993 or 1994 (depending on
which survey you believe) more Americans got their health
coverage through managed care plans.
Still, indemnity plans are the standard by which American health care plans
are measured. They remain the main alternative to managed care sys tems;
even though they’re mostly the choice of larger corporations and wealthier
individuals.
The conventional wisdom—within the medical profession and
among consumers—is that people with traditional indemnity
insurance get better treatment. And, most importantly, the
traditional plans give policyholders the assurance that any
decisions a health care provider makes are squarely in the
patient’s best interest.
But, we we will see in this chapter, these distinctions are not as
clear-cut as some people like to think.
WHAT "INDEMNITY" MEANS
When insurance people talk about indemnity insurance, the
thing that’s being indemnified is...you, the policyholder. An
indemnity insurance contract states that the insurance
company will pay your medical bills. In some cases, it will
reimburse the insured person for bills paid out-of-pocket; in
other cases, it will pay bills directly to the doctor or hospital
providing services. In either case, it pays fees for medical
services after they are provided.
This structure puts most of the decisions about health care and
treatment on the shoulders of the policyholders, who usually
defer to the suggestions that their doctors make.
With the service provider (the doctor) strongly influencing the decisions
about how much and what kind of service should be provided, at least one
truth emerges about indemnity coverage: It’s not very effective for
containing costs.
Because indemnity coverage was just about the only kind of
health insurance around in the United States during the first
three-quarters of the twentieth century, doctors and hospitals
made a lot of money...for a long time.
Conceptually, the coverage is pretty simple. In practice, it
comes with some qualifiers. Insurance companies recognized
pretty quickly that orthopedists in Miami and ob/gyn’s in
Seattle were driving Mercedes, building second houses and
sending their kids to Harvard—often at the same time.
So, the companies started to put limits on how much an
indemnity contract would…indemnify.
The first limit is the deductible. The deductible works this
way: The insurance company will pay the doctors and hospitals
bills—after you pay a small amount first. This small fee is
defined at the start of the policy period; and it’s usually
structured to spread over the whole period.
For example, the insurance company might indemnify you for
all medical costs after the first $500 each year...or the first $50
each month.
The point isn’t so much to get you to pay part of the cost as it is to make
sure you only go to the doctor when you’re really sick.
Said another way: It’s not that the insurance company needs
you to pay the first $50 in medical bills each month. The
company just figures that if you have to pay $50, you’re less
likely to go to the hospital with a low-grade fever.
In health coverage, as in other kinds of insurance, these up-
front fees are very effective at reducing bills generated by
policyholders.
Another limit is coinsurance. This modification is an effort to
get you to bear part of the cost.
In a contract with a coinsurance clause, the insurance company
agrees to pay a certain portion (80 percent is common) of the
medical bills you incur.
This shared burden applies from the first dollar of coverage to
the policy’s absolute limit. The rest— the other 20 percent—
you have to pay out-ofpocket.
This is a major compromise on the concept of full
indemnification. Insurance companies usually make it
financially appealing to take the lesser coverage.
It’s easy to calculate how much the insurance company wants
you to share the burden. Compare the annual premium for full
indemnity coverage with the annual premium for indemnity
coverage with an 80/20 coinsurance split. (Many companies
will sell both kinds of insurance.) The full indemnity coverage
should be about 25 percent more expensive. If it’s that much
more or less, the company doesn’t mind the risk—and you
should buy the full coverage. If it’s more than 25 percent more
—and most will be—you may be better off with the cheaper
coverage.
A caveat: Many indemnity policies have both a deductible and a coinsurance
clause. In these cases, you’ll probably want to focus your negoti ating
efforts on lowering your portion of the co insurance. The deductible doesn’t
usually im pact the value of the policy as much.
Another limit is that some indemnity policies don’t cover
specifically-named medical services. These may not cover
prescription drugs or routine doctor visits.
The final limit is the category of exclusions the indemnity
contract includes. Many companies will agree to pay medical
bills—except for those related to a list of specific illnesses or
conditions.
The best example of this: Many individual indemnity policies
exclude coverage for pregnancy and childbirth. The
companies look at this as an optional condition which has more
complexities—and hidden costs—than most people realize.
USUAL, CUSTOMARY AND REASONABLE FEES
Most of the limits and conditions we’ve considered so far
merely trim at the edges of indemnity health coverage. There
are bigger changes that have impacted—and usually limited—
coverage.
Beginning in the 1970s, some indemnity insurance companies
borrowed a few cost-saving tricks from the federal
government’s Medicare program and started using schedules
of usual, customary and reasonable (UCR) fees that they
would pay for specific kinds of medical treatments.
Approved providers (a group slightly less rigidly defined than
network providers in a managed care plan) would agree to
accept these fees as full payment for each service provided—
within the policy’s limits, of course.
This trend has caught on with indemnity companies to the point
they are quite common. UCR fees don’t get a lot of attention in
the insurance industry—which is curious. They are a big reason
that the distinctions between indemnity insurance and
managed care are beginning to blur.
If your indemnity insurance company uses an UCR fee schedule
—and if you don’t use a participating provider—you may be
responsible for the difference between the UCR fee and what
the provider charges for a service.
Even if you adhere to the UCR fee schedule, you’ll also be subject to any
deductibles and coinsur ance requirements.
As you can see, taken together, these coverage limitations
begin to erode the impression of blanket coverage that
indemnity plans have for most people. They are the tools that
even indemnity plans use for denying or only partially paying
claims.
TRADITIONAL INSURANCE VS. MANAGED CARE
If you want to share in the decision-making, greater flexibility
and direct access to providers, you’ll want to look into an
indemnity plan. If you want lower premiums, managed care will
usually work better.
Most people know this much about health insurance. But how
do these two main versions of health coverage compare in a
more detailed way? Here are some quick comparisons: •
Choice
Indemnity Insurance: You can select any doctor,
hospital or other health care provider.
Managed Care: You can select any health care provider
in the network. If you use a provider outside of the
network, you pay some or all of the bill.
• Seeing a specialist
Indemnity Insurance: You can use any specialist.
However, some plans require pre-approval for certain
procedures performed by specialists.
Managed Care: Your primary care doctor determines if
and when you need to see a specialist. (Sometimes you
can see a specialist who is part of the network without
permission.) If you use a specialist without HMO
approval (or outside the approved list), you will have to
pay the entire bill.
• Out-of-pocket costs
Indemnity Insurance: You may have to pay an annual
deductible of $200 to $1,000. You also may be
responsible for coinsurance payments of something like
20 percent of your medical bills, up to a certain limit
(the stop-loss amount) each year. Sometimes, you pay
for routine doctor visits and prescription drugs.
Managed Care: You may have to pay copayments
(usually $3 to $10) for network doctor visits and
prescription drugs. When you use a provider outside of
the network, you may have to pay a deductible—after
which the plan will pay part of the total charges.
In short, an indemnity plan—even with its limitations—offers
you the freedom of choice but usually requires you to pay
more out-of-pocket expenses than you would with an HMO or
PPO.
The idemnity plan may not cover you for any routine care—
annual checkups and other preventative treatments—either.
Some of these preventative treatments include:
blood tests,
prostate exams,
genetic trait tests,
hearing and sight loss,
electro-cardiogram (stress tests),
mammograms,
CAT scans (if you have a history of problems).
In an age of heavily-touted preventive medicine, the fact that
these treatments aren’t covered may seem strange.
Of course, you can get these services under an indemnity plan.
You just have to be willing to absorb the related costs—at
least large parts of them—by yourself.
CHOOSING A DOCTOR
An indemnity insurance plan will usually require you to choose
a primary care physician, if only to give the company a
recognizable name to use when reviewing medical bills.
This selection is much less critical than choosing a primary
physician under a managed care plan. For one thing, you can
choose any physician you wish and any health services to use.
You can also change “your doctor” any time you want—you just
have to let the insurance company know. (And, frankly, you
don’t even need to do that too scrupulously.) The same rule
applies to seeing specialists. An indemnity plan allows you to
go to any specialist whenever you prefer to—without having to
get a referral from your primary care physician.
An indemnity plan puts no limit on doctor visits, aside from your own
financial well-being. How ever, certain types of visits may not be covered
under an indemnity plan (i.e., mental health). you will have to bear the
brunt of the costs.
This is all different from managed care plans, in which you
choose a primary care physician from a list of doctors that your
health plan has contracted with to provide health services.
With an HMO, your primary care physician is your primary
contact for all health services. Instead of having a choice,
primary care doctor coordinates the services—provided by
specialists and others—that you will receive.
PRESCRIPTIONS
If you have an indemnity plan, prescriptions may or may not
be covered under your plan.
If it is covered, you may have to pay the larger portion while
your insurance company pays a smaller share for your
medications. However, you will have the option to choose either
the brand name or the generic drug.
PREVENTATIVE CARE
As we’ve noted, one major difference between an indemnity
plan and a managed care plan is that under the first, there are
typically no wellness educational programs.
Usually, when you have indemnity coverage, you seek care only
when it is needed for a particular condition. And bills are
paid only after the care is delivered.
Managed care plans stress prevention and offer programs to
help people learn about their conditions.
This applies to facilities as well as physicians. The indemnity
plan lets you choose to go to any hospital you wish—but it
doesn’t let you choose any service from that hospital. If you
submit bills from a hospital’s wellness program, they will likely
be denied.
During the 1970s and early 1980s, some indem nity insurance companies
did pay for certain wellness programs affiliated with hospitals. They
stopped doing this in the late 1980s and early 1990s. However, the
pendulum seems to be swining back in the late 1990s—as some indem nity
plans are allowing preventative care claims again.
DISPUTING DECISIONS
Unlike HMOs (which usually have to respond within six
months), traditional indemnity plans are not required to
respond to your complaints within a set time frame or have
provisions for a formal hearing or appeals process. But if you
are not satisfied with your insurer’s willingness to pay a claim,
you can ask for a reconsideration of the decision.
If you have problems getting reimbursed, an in demnity plan allows you to
choose your method of recourse, i.e., the court system or mediation. In
addition, you have the option to appeal any decision by your insurance
company to pay or deny a claim.
You can also file a complaint with your state’s Department of
Commerce (or equivalent agency)—and you don’t have to tell
your insurance company first. You will have to fill out a
complaint form and supply any information needed to support
your position to the Department.
Department investigators will usually then contact your
insurance company; and, if the problem cannot be resolved
within about 10 days, they will investigate whether the
insurance company followed the terms of your policy.
SUMMARY
In today’s business world, employers have come to rely on
managed care at the expense of traditional indemnity
insurance. In fact, many employers no longer offer traditional
insurance indemnity at all.
But economic realities and employee preferences clearly show
that, despite its dramatic growth, people want freedom to
choose their doctors and hospitals, and the networks that
include them.
One of the advantages of the indemnity plan is that there are
typically no limits on which providers you can use or how
often you see them.
While cost will be one of your biggest concerns in choosing a
plan, quality should also be an important consideration.
The concept behind an indemnity plan is to reduce your share
of the costs as much as possible—without compromising the
quality of the care you recieve.
Some insurance companies do this more aggressively than
others.
Generally, you have to shell out more for this type of plan—in
deductibles, copayments, premiums and out of pocket expenses
—but you have an unlimited amount of choices. So, if you don’t
have financial limitations holding you back and you want to
be able to go to the doctor you want, when you want and
wherever you want, you may want to look into an indemnity
plan.
Under a fee-for-service type plan, you pay a deductible—a fixed
amount that must be paid before your insurance company will
start to pay—and all costs for services that your insurance
company won’t pay for.
To recount, what are the advantages of traditional indemnity
insurance over an HMO?
• You can choose any doctor.
You can go to virtually any hospital, anywhere in the
country.
You can continue seeing the same doctor you always
have even if you change jobs or insurance
companies.
You have some assurance that your doctor’s medical
recommendations are being made in your best
interest— and not the insurance company’s.
Even if you choose an indemnity health coverage plan, you
can’t rest assured that everything will be covered. It’s
important to investigate and learn as much about the types of
policies available, the companies offering insurance, the
agent and the local company represented, what the policy will
or will not pay for, and how you will be reimbursed for visits,
prescriptions, etc.
Be sure to review your policy at least once a year. Today’s
healthcare system continues to change at a rapid pace and you
wouldn’t want to be making up the difference yourself in order
to meet these changing demands.
shouldered by business—has driven the problems in the
healthcare system.
Until the early 1980s, most people received health coverage
through a traditional indemnity or fee-for-service plan.
Under this type of plan, your insurance company pays all or
part of the bill for any doctor, hospital or other health care
provider that you may choose.
With traditional insurance, also called indemnity insurance, you are free to
visit the doctor of your choice. You can change to another doctor at any
time for any reason. And you can use any hospital or licensed medical
facility you choose.
Indemnity plans existed before the rise of HMOs, PPOs and
other types of managed care plans. How
ever, indemnity plans—with their focus on flexibility—aren’t
very effective at controlling costs. In the early 1990s,
indemnity plans lost their leading position in the U.S. health
coverage market. Starting in 1993 or 1994 (depending on
which survey you believe) more Americans got their health
coverage through managed care plans.
Still, indemnity plans are the standard by which American health care plans
are measured. They remain the main alternative to managed care sys tems;
even though they’re mostly the choice of larger corporations and wealthier
individuals.
The conventional wisdom—within the medical profession and
among consumers—is that people with traditional indemnity
insurance get better treatment. And, most importantly, the
traditional plans give policyholders the assurance that any
decisions a health care provider makes are squarely in the
patient’s best interest.
But, we we will see in this chapter, these distinctions are not as
clear-cut as some people like to think.
WHAT "INDEMNITY" MEANS
When insurance people talk about indemnity insurance, the
thing that’s being indemnified is...you, the policyholder. An
indemnity insurance contract states that the insurance
company will pay your medical bills. In some cases, it will
reimburse the insured person for bills paid out-of-pocket; in
other cases, it will pay bills directly to the doctor or hospital
providing services. In either case, it pays fees for medical
services after they are provided.
This structure puts most of the decisions about health care and
treatment on the shoulders of the policyholders, who usually
defer to the suggestions that their doctors make.
With the service provider (the doctor) strongly influencing the decisions
about how much and what kind of service should be provided, at least one
truth emerges about indemnity coverage: It’s not very effective for
containing costs.
Because indemnity coverage was just about the only kind of
health insurance around in the United States during the first
three-quarters of the twentieth century, doctors and hospitals
made a lot of money...for a long time.
Conceptually, the coverage is pretty simple. In practice, it
comes with some qualifiers. Insurance companies recognized
pretty quickly that orthopedists in Miami and ob/gyn’s in
Seattle were driving Mercedes, building second houses and
sending their kids to Harvard—often at the same time.
So, the companies started to put limits on how much an
indemnity contract would…indemnify.
The first limit is the deductible. The deductible works this
way: The insurance company will pay the doctors and hospitals
bills—after you pay a small amount first. This small fee is
defined at the start of the policy period; and it’s usually
structured to spread over the whole period.
For example, the insurance company might indemnify you for
all medical costs after the first $500 each year...or the first $50
each month.
The point isn’t so much to get you to pay part of the cost as it is to make
sure you only go to the doctor when you’re really sick.
Said another way: It’s not that the insurance company needs
you to pay the first $50 in medical bills each month. The
company just figures that if you have to pay $50, you’re less
likely to go to the hospital with a low-grade fever.
In health coverage, as in other kinds of insurance, these up-
front fees are very effective at reducing bills generated by
policyholders.
Another limit is coinsurance. This modification is an effort to
get you to bear part of the cost.
In a contract with a coinsurance clause, the insurance company
agrees to pay a certain portion (80 percent is common) of the
medical bills you incur.
This shared burden applies from the first dollar of coverage to
the policy’s absolute limit. The rest— the other 20 percent—
you have to pay out-ofpocket.
This is a major compromise on the concept of full
indemnification. Insurance companies usually make it
financially appealing to take the lesser coverage.
It’s easy to calculate how much the insurance company wants
you to share the burden. Compare the annual premium for full
indemnity coverage with the annual premium for indemnity
coverage with an 80/20 coinsurance split. (Many companies
will sell both kinds of insurance.) The full indemnity coverage
should be about 25 percent more expensive. If it’s that much
more or less, the company doesn’t mind the risk—and you
should buy the full coverage. If it’s more than 25 percent more
—and most will be—you may be better off with the cheaper
coverage.
A caveat: Many indemnity policies have both a deductible and a coinsurance
clause. In these cases, you’ll probably want to focus your negoti ating
efforts on lowering your portion of the co insurance. The deductible doesn’t
usually im pact the value of the policy as much.
Another limit is that some indemnity policies don’t cover
specifically-named medical services. These may not cover
prescription drugs or routine doctor visits.
The final limit is the category of exclusions the indemnity
contract includes. Many companies will agree to pay medical
bills—except for those related to a list of specific illnesses or
conditions.
The best example of this: Many individual indemnity policies
exclude coverage for pregnancy and childbirth. The
companies look at this as an optional condition which has more
complexities—and hidden costs—than most people realize.
USUAL, CUSTOMARY AND REASONABLE FEES
Most of the limits and conditions we’ve considered so far
merely trim at the edges of indemnity health coverage. There
are bigger changes that have impacted—and usually limited—
coverage.
Beginning in the 1970s, some indemnity insurance companies
borrowed a few cost-saving tricks from the federal
government’s Medicare program and started using schedules
of usual, customary and reasonable (UCR) fees that they
would pay for specific kinds of medical treatments.
Approved providers (a group slightly less rigidly defined than
network providers in a managed care plan) would agree to
accept these fees as full payment for each service provided—
within the policy’s limits, of course.
This trend has caught on with indemnity companies to the point
they are quite common. UCR fees don’t get a lot of attention in
the insurance industry—which is curious. They are a big reason
that the distinctions between indemnity insurance and
managed care are beginning to blur.
If your indemnity insurance company uses an UCR fee schedule
—and if you don’t use a participating provider—you may be
responsible for the difference between the UCR fee and what
the provider charges for a service.
Even if you adhere to the UCR fee schedule, you’ll also be subject to any
deductibles and coinsur ance requirements.
As you can see, taken together, these coverage limitations
begin to erode the impression of blanket coverage that
indemnity plans have for most people. They are the tools that
even indemnity plans use for denying or only partially paying
claims.
TRADITIONAL INSURANCE VS. MANAGED CARE
If you want to share in the decision-making, greater flexibility
and direct access to providers, you’ll want to look into an
indemnity plan. If you want lower premiums, managed care will
usually work better.
Most people know this much about health insurance. But how
do these two main versions of health coverage compare in a
more detailed way? Here are some quick comparisons: •
Choice
Indemnity Insurance: You can select any doctor,
hospital or other health care provider.
Managed Care: You can select any health care provider
in the network. If you use a provider outside of the
network, you pay some or all of the bill.
• Seeing a specialist
Indemnity Insurance: You can use any specialist.
However, some plans require pre-approval for certain
procedures performed by specialists.
Managed Care: Your primary care doctor determines if
and when you need to see a specialist. (Sometimes you
can see a specialist who is part of the network without
permission.) If you use a specialist without HMO
approval (or outside the approved list), you will have to
pay the entire bill.
• Out-of-pocket costs
Indemnity Insurance: You may have to pay an annual
deductible of $200 to $1,000. You also may be
responsible for coinsurance payments of something like
20 percent of your medical bills, up to a certain limit
(the stop-loss amount) each year. Sometimes, you pay
for routine doctor visits and prescription drugs.
Managed Care: You may have to pay copayments
(usually $3 to $10) for network doctor visits and
prescription drugs. When you use a provider outside of
the network, you may have to pay a deductible—after
which the plan will pay part of the total charges.
In short, an indemnity plan—even with its limitations—offers
you the freedom of choice but usually requires you to pay
more out-of-pocket expenses than you would with an HMO or
PPO.
The idemnity plan may not cover you for any routine care—
annual checkups and other preventative treatments—either.
Some of these preventative treatments include:
blood tests,
prostate exams,
genetic trait tests,
hearing and sight loss,
electro-cardiogram (stress tests),
mammograms,
CAT scans (if you have a history of problems).
In an age of heavily-touted preventive medicine, the fact that
these treatments aren’t covered may seem strange.
Of course, you can get these services under an indemnity plan.
You just have to be willing to absorb the related costs—at
least large parts of them—by yourself.
CHOOSING A DOCTOR
An indemnity insurance plan will usually require you to choose
a primary care physician, if only to give the company a
recognizable name to use when reviewing medical bills.
This selection is much less critical than choosing a primary
physician under a managed care plan. For one thing, you can
choose any physician you wish and any health services to use.
You can also change “your doctor” any time you want—you just
have to let the insurance company know. (And, frankly, you
don’t even need to do that too scrupulously.) The same rule
applies to seeing specialists. An indemnity plan allows you to
go to any specialist whenever you prefer to—without having to
get a referral from your primary care physician.
An indemnity plan puts no limit on doctor visits, aside from your own
financial well-being. How ever, certain types of visits may not be covered
under an indemnity plan (i.e., mental health). you will have to bear the
brunt of the costs.
This is all different from managed care plans, in which you
choose a primary care physician from a list of doctors that your
health plan has contracted with to provide health services.
With an HMO, your primary care physician is your primary
contact for all health services. Instead of having a choice,
primary care doctor coordinates the services—provided by
specialists and others—that you will receive.
PRESCRIPTIONS
If you have an indemnity plan, prescriptions may or may not
be covered under your plan.
If it is covered, you may have to pay the larger portion while
your insurance company pays a smaller share for your
medications. However, you will have the option to choose either
the brand name or the generic drug.
PREVENTATIVE CARE
As we’ve noted, one major difference between an indemnity
plan and a managed care plan is that under the first, there are
typically no wellness educational programs.
Usually, when you have indemnity coverage, you seek care only
when it is needed for a particular condition. And bills are
paid only after the care is delivered.
Managed care plans stress prevention and offer programs to
help people learn about their conditions.
This applies to facilities as well as physicians. The indemnity
plan lets you choose to go to any hospital you wish—but it
doesn’t let you choose any service from that hospital. If you
submit bills from a hospital’s wellness program, they will likely
be denied.
During the 1970s and early 1980s, some indem nity insurance companies
did pay for certain wellness programs affiliated with hospitals. They
stopped doing this in the late 1980s and early 1990s. However, the
pendulum seems to be swining back in the late 1990s—as some indem nity
plans are allowing preventative care claims again.
DISPUTING DECISIONS
Unlike HMOs (which usually have to respond within six
months), traditional indemnity plans are not required to
respond to your complaints within a set time frame or have
provisions for a formal hearing or appeals process. But if you
are not satisfied with your insurer’s willingness to pay a claim,
you can ask for a reconsideration of the decision.
If you have problems getting reimbursed, an in demnity plan allows you to
choose your method of recourse, i.e., the court system or mediation. In
addition, you have the option to appeal any decision by your insurance
company to pay or deny a claim.
You can also file a complaint with your state’s Department of
Commerce (or equivalent agency)—and you don’t have to tell
your insurance company first. You will have to fill out a
complaint form and supply any information needed to support
your position to the Department.
Department investigators will usually then contact your
insurance company; and, if the problem cannot be resolved
within about 10 days, they will investigate whether the
insurance company followed the terms of your policy.
SUMMARY
In today’s business world, employers have come to rely on
managed care at the expense of traditional indemnity
insurance. In fact, many employers no longer offer traditional
insurance indemnity at all.
But economic realities and employee preferences clearly show
that, despite its dramatic growth, people want freedom to
choose their doctors and hospitals, and the networks that
include them.
One of the advantages of the indemnity plan is that there are
typically no limits on which providers you can use or how
often you see them.
While cost will be one of your biggest concerns in choosing a
plan, quality should also be an important consideration.
The concept behind an indemnity plan is to reduce your share
of the costs as much as possible—without compromising the
quality of the care you recieve.
Some insurance companies do this more aggressively than
others.
Generally, you have to shell out more for this type of plan—in
deductibles, copayments, premiums and out of pocket expenses
—but you have an unlimited amount of choices. So, if you don’t
have financial limitations holding you back and you want to
be able to go to the doctor you want, when you want and
wherever you want, you may want to look into an indemnity
plan.
Under a fee-for-service type plan, you pay a deductible—a fixed
amount that must be paid before your insurance company will
start to pay—and all costs for services that your insurance
company won’t pay for.
To recount, what are the advantages of traditional indemnity
insurance over an HMO?
• You can choose any doctor.
You can go to virtually any hospital, anywhere in the
country.
You can continue seeing the same doctor you always
have even if you change jobs or insurance
companies.
You have some assurance that your doctor’s medical
recommendations are being made in your best
interest— and not the insurance company’s.
Even if you choose an indemnity health coverage plan, you
can’t rest assured that everything will be covered. It’s
important to investigate and learn as much about the types of
policies available, the companies offering insurance, the
agent and the local company represented, what the policy will
or will not pay for, and how you will be reimbursed for visits,
prescriptions, etc.
Be sure to review your policy at least once a year. Today’s
healthcare system continues to change at a rapid pace and you
wouldn’t want to be making up the difference yourself in order
to meet these changing demands.
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.