| Health insurance coverage can be categorized into 2 major categories:
-Indemnity plans
-manage care plans
Indemnity plans
An indemnity plan reimburses you for your medical expenses, regardless of who provides the service. In some situations/types of coverage, this amount may be limited. The coverage offered by most insurers is in the form of an indemnity plan.
Different plans use different methods for determining how much you will be reimbursed for your medical expenses. Below are some common methods of reimbursement:
Reimbursement--percentage of actual charges
Under this plan, the insurer pays a percentage of the actual charges for covered procedures and services, regardless of how much they cost. A common reimbursement percentage is 80%. This has the same effect as a 20% co-payment.
Reimbursement--actual charges
Under this type of plan, the insurer will reimburse you for the actual cost of specified procedures or services, regardless of how much that cost may be.
Indemnity
Under this type of plan, the insurer pays a specified amount per day for a specified maximum number of days. Although your reimbursement amount does not depend on the actual cost of your care, your reimbursement will never exceed your expenses. |
