Presentation on theme: " Indemnity or Fee-for-Service coverage- -allow you go to the doctor of your choice and pay for services at the time of the visit. -The amount that your."— Presentation transcript:
Indemnity or Fee-for-Service coverage- -allow you go to the doctor of your choice and pay for services at the time of the visit. -The amount that your health insurance company will pay is a predetermined benefit level of covered medical expenses, based on your deductible and co-insurance amounts. -To receive payment for medical expenses, you may have to fill out forms and send them to your insurer and are responsible for keeping track of all your medical expenses. Health maintenance organizations (HMO)- - you pay a fixed monthly fee called a premium. -the health insurance company and its physician network provide a variety of medical benefits. -The primary care physician you choose from this network is responsible for your health care as well as for making referrals to specialists and approving further medical treatment. -Usually, your choice of doctors and hospitals is limited to those within the network since they have agreements with the HMO to provide your health care. - care received outside of the health care network is not covered. Preferred provider organizations (PPO)- - operate like an HMO in that you pay a fixed monthly premium, and the health insurance company and its health care network provide medical benefits to you. -However, under a PPO insurance plan, a primary care physician is not required. As a result, seeing a specialist does not require a referral. -If you need or want health care from outside the network, you should expect to pay a higher co-payment or co-insurance than if the provider were from within the PPO network. - each time you need medical attention, you can decide between a higher costing plan with freedom of choice or a lower costing plan that restricts your care to within a network.