Fee for Service Plans: Referrals

If you are paying the substantial premium amounts and all the additional costs associated with a fee for service plan, you are paying for complete freedom within the health care industry. You can see any doctors you want at anytime without the restrictions that managed health care plans usually have, and there are no referrals to worry about.

No Restrictions or Referrals

Fee for service health plans are the most expensive type of health insurance out there, due in most part to the flexibility the plan provides. Also, doctors do not have to follow any financial guidelines imposed by a larger organization. They are free agents, operating on their own and if they choose to, they can build their own price bracket around their services.

FFS Payments

You can see any doctor that you like as a member of a fee for service insurance plan. After you meet your deductible, the insurance company will make some financial contributions to offset the cost of your medical expenses. The cost for services rendered will be under a coinsurance structure where both the insured and the insurer are responsible for the financial obligation. That cost to the policyholder can be 30%+ of the medical bill.

Additionally, since there is no referral system required for a fee for service medical insurance plan, it is important to realize that the insurance company will need to control their costs someway. If they find your doctor is charging more than what is “usual, customary and reasonable,” you will be saddled with the responsibility of paying the additional portion of your charges.