Managed Care And Indemnity Plans: I'm So Mad I Didn't Know This Before!
You may frequently hear managed care and indemnity health insurance plans discussed in the news. These two types of health plans differ greatly in how they provide health care, with the nature of choice in each type of plan being the key area of difference.
When you are a part of a managed health care plan you will be required to visit certain hospitals, doctors, and pharmacies. This is because these providers have a contract with your insurance. When you visit the participating providers you will have less paperwork and it will cost less to you as well. There are three kinds of managed care programs that you can look at.
The PPO (or preferred provider organization) combines managed and indemnity to come up with its own flavor. You can choose from professionals in the PPO network or outside the network. If you choose outside the network you simply pay the bill and then submit for reimbursement. If you choose a PPO doctor, you will pay a nominal flat fee for service.
HMO (or health maintenance organization) requires you to pay when you see an HMO doctor, but there is no plan deductible. HMO will give you a list of doctors to help you choose a primary doctor.
On the other hand, the indemnity plans will offer you a wider choice of health care professionals to choose from because these plans have no predefined contracts. You can expect to outlay higher amounts. Generally you pay the bill and then submit it. Deductibles start at $200 and go up and most plans cover 80% although there are variations.
Over time the distinctions between these two plans have begun to blur. Some indemnity plans are beginning to have some of the features of managed care plans.
There may be some shops that use online services providing immediate health insurance quotes. Sometimes they are provided free of charge but a person has to fill a short form that makes him get many quotes from nearby insurance agents. With the help of the information collected from the form, the person and his family members' risk will be evaluated as they will be covered by the policy. The premiums and restrictions that the policy has will then be decided.
Whatever form of health insurance you eventually settle upon will most likely depend on your specific health care needs and those of your family. By doing a little research to understand the different kinds that are available, you will be much better armed to make an informed choice that make sense for your situation.
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Published January 3rd, 2008
Filed in Health
