Understanding Indemnity Health Care Coverage Insurance Plans

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A compensable health insurance plan is a health care plan that allows you to choose the doctor, health care professional, hospital or service provider of your choice and gives you the greatest flexibility and freedom in a health insurance plan.

Health compensation plans are also known as:

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traditional compensation plan
package paid
The plan helps provide protection against medical bills.

Benefits of health insurance compensation plans
The Health Compensation Policy is different from the policies offered by Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO) because it allows you to obtain medical care when you choose to compensate. a health care claim. defined portion of costs. A key feature of the indemnity health insurance plan is that it does not require you to choose a primary care physician. Compensatory health insurance plans are also unique in that they allow you to refer to specialists yourself, they do not require you to obtain a referral in order to be compensated.

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The type of freedom offered by a compensatory health insurance plan can be helpful in directing your own health care. This is very different from HMOs, RPNs, and PPOs that use managed care and may require you to choose a primary care provider as part of the plan.

Compensatory health insurance schemes do not involve a network of providers2.

Is Compensatory Health Insurance Right For You and Your Family?
Health insurance compensation plans are more beneficial if the following are important to you:

You don’t want to commit to a primary care physician. A health care compensation plan doesn’t require you to choose your primary doctor, so it gives you the freedom to choose.
You don’t mind paying a little more for your health insurance costs or deductible.
You don’t have to worry about selecting suppliers whose costs are not approved. This means that, since you are not part of a network in a compensatory health insurance plan, the fees for the doctors and specialists that you choose may go beyond the definition of the usual, customary and reasonable amount (UCR). . . . .5 You will need to pay attention to how your choices affect your costs.
You live in a geographic area where access to the doctors and medical services you want would not be included in an HMO or PPO plan.
Compensation Health insurance costs and deductibles
Compensation insurance plans pay a portion of your medical expenses to the service provider of your choice, but may be subject to the deductible. The deductible in a compensation plan can vary from $ 100 for individuals and up to $ 500 on average for families and varies by insurance company.6

Once you’ve paid the deductible, the plan will pay the rest of your health insurance costs up to the maximum limits of your contractual agreement.

Compensation policies may also include quota or coinsurance clauses.7

4 important keys to understanding a compensatory health insurance plan
If you have the option of choosing a health insurance compensation policy, here are four important points to remember:

1. Compensation plans and usual, customary and reasonable rate (DUC)
UCR rates are the amounts that medical service providers in your area typically charge for the services because compensation plans are self-administered health insurance plans. There is no network specifying the rates that the selected providers will charge. Therefore, you’ll want to familiarize yourself with the costs that your plan designates as UCR versus what your chosen provider will charge for the services to avoid unforeseen costs. In general, most providers meet the criteria, but it is important to be informed when using a self-administered plan such as a compensatory health insurance plan.8

2. Understand deductibles and co-payments for indemnity health insurance
The deductible is the amount you have to pay before the policy benefits are provided. After the deductible, you may have to pay a co-payment. A copayment is a percentage you pay of the remaining fees after your deductible. For example: if your eligible expenses are $ 800 and you have a deductible of $ 200, you have $ 600 left. Let’s say your co-payment is 20%. This means that you still have to pay 20% of the remaining 600 USD, which is 120 USD.

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