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Today Fee-For-Service (also called “Indemnity”) plans are the Cadillacs of the health insurance world. They are for those who want the full freedom to choose their own doctors and specialists as they see fit and who don’t mind paying extra for that freedom. They are also a good fit for someone who travels regularly, especially outside the U.S.
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How Fee-For Service Plans Compare
- Greatest freedom
- Most expensive
Fee-For-Service plans are traditional insurance plans, handled the way all health insurance was handled before “managed care” (that is, HMOs, PPOs, etc.) came along. In short, you pay the insurance company a monthly premium. When you receive medical care, the insurance company covers a portion of it.
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Important Points About Fee-For-Service Plans
- You have complete freedom to choose any doctor you like. Generally there is no preferred network to consider.
- You don’t need a doctor’s referral to see a specialist. Benefits cover all specialists equally.
- Fee-For-Service plans have a deductible before coverage starts. In general, the higher the deductible, the lower your rate.
- Once you’ve met your annual deductible, you will also be responsible for paying coinsurance. This is the amount of medical expense not paid by the insurer. Usually insurers cover 70-80% of costs above the deductible.
- Most Fee-For-Service plans do not cover preventive care, such as routine checkups and health screenings, until you’ve met your annual deductible.
- Fee-For-Service plans may require a certain amount of paperwork on your part. Some doctors will work directly with your insurance company and file claim forms for you. In some cases, however, you may need to pay up-front for service and file claim forms to receive reimburse
- There are different types of Fee-For-Service plans. Check with the insurance company of your choice for details.
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You Might Not Want a Fee-for-Service Plan If...
- You are looking for a lower monthly rate.
See the HMO, PPO, POS, SDHP or HSA plans sections.
- You’re “allergic” to paperwork.
See the HMO section.
- You’d like your preventive care to be covered.
See the HMO and SDHP Plans sections.
For details on which Fee-For-Service plans are offered in your area, please see the Texas-Health-Plans Providers List.
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