An indemnity plan is a health care plan that provides cash payment for designated covered services to physicians, hospitals, and other providers. Payments may be made directly to service providers or as reimbursement to plan members.
Employees with indemnity plans as medical insurance have absolute freedom of choice in selecting a physician or specialist. These plans, which are more expensive than some alternatives, still use old methods such as claim forms and reimbursement checks. Also known as fee-for-service.
a health plan that is not tied to any particular network. Participants may use any provider, however a deductible must be met before any services are covered, participants must file their own claims and may be responsible for paying the difference between the Usual, Customary and Reasonable charge and what the provider charges.
A health insurance plan where patients may select any doctor or hospital, and providers bill the patient or the insurance company their normal fees for their services. Providers have no relationship with the health plan, although most submit claims and accept payments from the plan on behalf of the patient. Coverage is usually provided for conditions caused by illness or injury and related diagnostic tests, and usually excludes routine screening and preventive care/checkups. "Fee-for-Service" sometimes is used as a synonym.
a dental or medical plan that reimburses for services no matter who the patient chooses to provide the services
a disease that causes severe and swift decay of baby dental insurance for the self employed teeth
a fully insured or self-insured plan where an assigned payment is provided for specific services, regardless of the actual charges made by the provider
a traditional health insurance plan that requires you to pay coinsurance amounts and certain deductibles
a type of healthcare coverage often called traditional health insurance
a type of health care insurance that generally does not restrict a patient's choice of doctors and medical institutions
Plan which restores or reimburses one to the extent of their loss.
A traditional fee-for-service group health insurance plan in which employees choose whichever doctor and hospital they want to use each time they need care. Under this type of plan, employees may be responsible for filing their own claims for reimbursement. These plans typically require a deductible to be met, as well as co-insurance for all covered services.
Under the Indemnity Plan, you can use any medical provider (such as a doctor and hospital). Before your insurance company begins to pay for your expenses, you must meet your deductible. After you meet your deductible, you may be responsible for 20 to 50% of each medical expense, which is co-insurance. The insurance company will pay each remaining balance. See Usual, Customary and Reasonable Fees.
traditional dental insurance. The insurance company agrees to pay a percentage of dental fees up to an annual maximum. There may also be co-payments and deductibles. The percentage is based on the insurance company’s definition of “usual and customary” fees, not the dentist’s actual fee. Patients control selection of and access to the physician.
Traditional insurance arrangement under which the insurance provider agrees to reimburse the plan participants for specific health services. The insurer can make the payment to the plan participant or directly to the health care provider.
Indemnity insurance allows people to go to any doctor, hospital, or other provider (which bills for each service given), and the insurance and the patient pays part of the bill.
A health care plan in which any provider can be used. The enrollee is reimbursed for expenses or assigns the reimbursement to the provider. Also called a traditional or fee-for-service plan.
Also known as fee for service plan. In this type of plan the insurance company agrees to provide dental care for a specific group/population for an agreed upon period of time for an actuarially established per capita premium. The financial risk is assumed by the insurance carrier.
A type of health insurance coverage that lets you choose your own doctors and pays for your medical expenses—either totally, in part, or up to a specified amount per day for a specified number of days. This is also known as a reimbursement plan.
A health plan that allows you to go to any physician or provider you choose, but requires that you pay for the services yourself and file claims for reimbursement. (Also known as fee-for-service.)
Indemnity insurance plans are an alternative to managed care plans. These plans charge consumers a set amount for coverage and reimburse (fully or partially) consumers for most medical services.
A dental plan where a third-party payer provides payment of an amount for specific services, regardless of the actual charges made by the provider. Payment may be made either to enrollees or, by assignment, directly to dentists. Schedule of allowances, table of allowances, or reasonable and customary plans are examples of indemnity plans.
A plan which reimburses physicians for services performed, or beneficiaries for medical expenses incurred. Such plans are contrasted with group health plans, which provide service benefits through group medical practice.
Traditional fee-for-service health insurance in which members have free choice of physicians.
A non PPO or HMO plan, a plan that does not have preferred provider networks or many cost containment features.
A medical or dental plan which allows you to choose any licensed provider to provide health care. Members are reimbursed for eligible medical or dental expenses according to the benefit schedule in effect, including deductibles and coinsurance.
A type of coverage that lets you choose your own doctors and pays for your medical expenses. It is rarely offered by businesses today because of the cost.
Traditional health insurance that usually covers a percentage of the cost of care (often 80%) after the consumer pays an annual deductible. Patients with indemnity coverage can choose any doctor or hospital for their care.
With an indemnity plan (sometimes called fee-for-service), you can use any medical provider (such as a doctor and hospital). You or they send the bill to the insurance company, which pays part of it. Usually, you have a deductible—such as $200—to pay each year before the insurer starts paying. Once you meet the deductible, most indemnity plans pay a percentage of what they consider the "Reasonable and Customary" charge for covered services. The insurer generally pays 80 percent of the Reasonable and Customary costs and you pay the other 20 percent, which is known as co-insurance. If the provider charges more than the Reasonable and Customary rates, you will have to pay both the co-insurance and the difference. The plan will pay for charges for medical tests and prescriptions as well as from doctors and hospitals. It may not pay for some preventive care, like checkups.
A traditional indemnity plan allows members flexibility in their choice of recognized health care providers. Members are responsible for seeking care, initiating precertification, paying for services rendered, and submitting claims for reimbursement of covered services at a predetermined coinsurance rate.
The traditional plan like previous BCBS coverage providing the greatest access to doctors and hospitals desired. You pay an annual $200 deductible, then plan pays 80% of covered expenses. Once you pay the next $1000 out of your own pocket, the plan pays 100% for the rest of the year.