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"Traditional" health insurance | Managed care | Preferred Provider Organizations (PPOs)
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"TRADITIONAL" HEALTH INSURANCE
| Up until about 30 years ago, most people had traditional indemnity coverage. These days, it's often known as "fee-for-service". Indemnity plans are a bit like auto insurance: you pay a certain amount of your medical expenses up front--in the form of a deductible--and afterward the insurance company pays the majority of the bill. Advances in modern medicine increased the cost of providing health care and made it possible for people to live longer. Those advances caused many insurance companies to look for ways to reduce their costs of doing business, giving managed care the boost it enjoys today. For years, indemnity or fee-for-service coverage was the norm. Under this type of health coverage, you have complete autonomy when it comes to choosing doctors, hospitals and other health care providers. You can refer yourself to any specialist without getting permission, and the insurance company doesn't get to decide whether the visit was necessary. You don't, however, have complete autonomy. Most fee-for-service medicine is managed to a certain extent. For instance, if you're not already incapacitated, you may need to get clearance for a visit to the emergency room. In a nutshell, fee-for-service coverage offers flexibility in exchange for higher out-of-pocket expenses, more paperwork and higher premiums. |
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