is Indemnity Health Insurance?
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 who pays part of
it. Usually, you have a deductible, the amount of the covered expenses
you must pay before the insurer starts to reimburse you -- such
as $200 -- which you pay each year before the insurer starts paying.
Once you meet the deductible, most indemnity plans pay a percentage
of what they consider the usual
and customary charge for covered services. The insurer generally
pays 80 percent of the usual and customary costs and you pay the
other 20 percent known as coinsurance. If the provider charges more
than the usual and customary rates, you must pay both the coinsurance
and the excess charges.
For example, if the usual and customary fee for a medical service
is $100, the insurer will pay $80 and you will pay $20. However,
if the doctor charges $105, you will pay $25. Note that many fee-for-service
plans pay hospital expenses in full; some reimburse at the 80/20
level as described above. policies typically have an out-of-pocket
maximum. This means that once your expenses reach a certain
amount in a given calendar year, the usual and customary fee for
covered benefits will be paid in full by the insurer and you no
longer pay the coinsurance. If your doctor bills you more than the
usual customary charge, again you may still have to pay a portion
of the bill.
There also may be lifetime
limits on benefits paid under the policy. Most experts recommend
that you look for a policy whose lifetime limit is at the very least
$1 million. Anything less may prove to be inadequate.
Licensed for health insurance:
Ohio License #104233, Florida License #D07271, California License #0C94325
Licensed agents in:
California, Colorado, Connecticut, Alabama, Alaska, Arizona, Arkansas, Delaware, D.C., Florida, Georgia, Hawaii, Illinois, Indiana, Idaho, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Mississippi, Michigan, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming