Indemnity Plans
When you shop for health insurance online, you often hear about HMO and PPO plans, but there is another type of health insurance policy organization out there, and it is called an indemnity plan. With an indemnity plan, there is no need for you to visit a certain network of doctors. Since this is a strict requirement of HMO plans and an activity that affords major discounts in a PPO plan, the ability to have absolutely no network of doctors in an indemnity plan is a great benefit.
The Benefits of Indemnity Plans
In addition to being given the freedom to visit any physician or specialist you want under an indemnity plan, you will also not generally be required to choose a primary care physician. This means you also won’t be forced to get referrals before you visit a specialist.
The Potential Drawbacks of Indemnity Plans
One of the drawbacks to an indemnity plan is that you must generally pay all your medical expenses out of pocketed then get reimbursed by the insurance company. Many consumers do not have the money at hand necessary to pay all expenses out of pocket initially, so this type of plan is not appropriate for every individual.
Another drawback to indemnity plans is that the insurance company will generally only reimburse you the “usual and customary” rate for your medical expenses, regardless of what they actually cost. The usual and customary rate is the average of what healthcare providers in your area charge for services. But because you are not dealing with a network of providers (like in a PPO and HMO) who have already agreed to charge that rate for services, you may have higher out of pocket expenses with an indemnity plan.
Like other insurance plans, you may need to choose deductibles and limits when you shop for indemnity health insurance online. While the monthly premiums may look attractive when you choose extremely high deductibles and low limits, make sure you choose deductibles you can actually afford to pay out of pocket for and that you choose reasonable limits.
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Facts about indemnity or reimbursement plans and Managed Care Plans.