What is indemnity health insurance mean?

Question

I can sign up for health insurance under an HMO plan, a PPO plan or an indemnity plan? What is an indemnity plan?

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Answer 1

What is an Indemnity Plan?
An indemnity plan is commonly known as a fee for service or traditional plan. A traditional plan allows you to use any doctor. Most indemnity plans require you to pay a deductible. After you have paid your deductible, indemnity policies typically pay a percentage of "usual and customary" charges for covered services; often the insurance company pays 80% and you pay 20%. Most plans have an annual out of pocket maximum and once you've reached this they will pay 100% of all "usual and customary" charges for covered services. You must submit a claim to the carrier for reimbursement of the covered amount.

What is a PPO Plan?
A Preferred Provider Organization (PPO) is a health insurance plan which features a network of participating providers with whom the insurance company has negotiated discounts for its members. When you select a PPO, you are free to use any doctor. If you select a nonparticipating provider (out-of-network), you will pay more. Most PPO plans have an annual deductible. You will pay for the first $250 to $5000 in services you receive each calendar year. After you have met your deductible, you will pay a percentage (coinsurance) - usually between 10% and 50% of the negotiated fee. Prescription drug coverage may be included or optional. In-network providers bill the carrier directly. You must submit a claim for out-of-network services

What is an HMO Plan?
A Health Maintenance Organization (HMO) offers comprehensive medical coverage through an exclusive network of providers. When you select an HMO, your medical care will be guided by a Primary Care Physician, who will refer you to a specialist when needed. In an HMO plan you must seek medical care within your provider network. Exceptions are made for emergencies. Generally HMO Plans offer the most comprehensive coverage for the premium dollar. Your out-of-pocket expenses usually are limited to a modest co-payment for a doctor visit or prescription drugs. No claim forms are needed.

What is a POS Plan?
Point of Service (POS) plans combine features of both HMO and PPO plans. POS plans offer three options at the time care is provided. (1) you may choose to receive care from your Primary Care Physician a for a small co-payment and no deductible, (2) you may choose to receive care from any in-network provider without a PCP referral and pay a larger co-payment plus the deductible, or (3) you may choose to receive care from any nonparticipating provider and pay a still larger co-payment plus the deductible. You may think of it an HMO plan with an escape clause.

What is an HSA Plan?
An HSA works like an IRA, except that money is used to pay health care costs. Participants enroll in a relatively inexpensive high deductible insurance plan. Then, a tax-deductible savings account may be opened to cover current and future medical expenses. The money deposited, as well as the earnings, is tax-deferred. The money can then be withdrawn to cover qualified medical expenses tax-free. Unused balances roll over from year to year.

How do I determine if my doctor or hospital belongs to one of the plan networks?
Most PPO and HMO plans have online provider directories.

Who qualifies as a dependent?
Dependents are eligible if they are a spouse or any unmarried child (adopted, stepchild or recognized natural child) under age 23 who maintains with the employee a regular parent/child relationship.

Can I be turned down?

Yes. Individual health insurance plans are not guaranteed issue. Your application includes a health history questionnaire which will be reviewed by the carrier's underwriting department. It the company decides not to accept the risk you will be denied.

Can I be charged a higher premium, but accepted?
Yes. Some companies have a multi-tier pricing structure. Perceived risks can be rated-up by 20% or 50%.

Do these plans have waiting periods or exclusions?
There are no waiting periods or exclusions on covered services when you select an HMO. Depending on whether you had health insurance within specified periods prior to enrolling, there may be waiting periods or exclusions of up to 12 months on specific covered services when you select a PPO or Traditional Plan.

Answer 2

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Answer 3

Indemnity is an actual insurance plan, unlike an HMO or PPO, which are better described as health care plans than insurance. Think of how your car insurance works. You get the health care you need and submit a claim. nonickname gave a good explanation of how each type of plan works.

Answer 4

What Is Indemnity Mean

Answer 5

An indemnity means you pay all the bills, submit proof you paid, then they'll pay you back part of it.

An indemnity plan gives you the broadest coverage with the most service options, but generally costs you the most in out of pocket expenses.

Answer 6

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RE :What is indemnity health insurance mean?
I can sign up for health insurance under an HMO plan, a PPO plan or an indemnity plan? What is an indemnity plan?

Thanks
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Answer 7

http://personalinsure.about.com/od/health/a/aa020606a.htm