Fee-For-Service Plans Current Rates, News & Information

Fee for Service Plans: Copayments

Posted in Fee-For-Service Plans , Health Insurance

September 29th, 2009
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A fee for service plan (traditional health care insurance) is the most expensive type of health care insurance you can choose. However, that extra money spent entitles the policyholders to freedom of choice and not having to deal with any type of referral network for medical treatment.

Copayment Structure

Within a fee for service plan, the copayment structure works as a coinsurance arrangement between the policyholder and the insurance provider. Members of a fee for service plan are expected to share the financial burden of their medical expenses with the insurance company. The expenses are shared in several ways including:

• High premiums
• Deductible limits that must be met
• Copayment amounts that can range from 20%-30% of the total medical bill

The copayment benefits for a fee for service plan will only kick in after a deductible is met. A deductible is the amount of money that an insurer needs to pay off before the benefit portion of a plan will kick in. The deductible is an annual limit and for fee for service plans, the amount can range in the thousands of dollars.

Submitting for Reimbursements

To get the copayment portion of the fee for service plan to work, a member will pay out-of-pocket first and then submit their own paperwork to the insurance company. After the deductible is met, the copayments will kick in and the insured will receive reimbursements from the insurance company typically covering 70%-80% of their initial costs.

It is important to note that the actual amount of reimbursement for the copayment will not only fluctuate between policies, but also at the insurance company’s discretion. The insurance provider will deem what are the “usual, customary and reasonable” costs for treatment by location. If that does not kick in, you will be responsible for those costs.

Fee for Service Plans: Referrals

Posted in Fee-For-Service Plans , Health Insurance

September 28th, 2009
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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.

Fee for Service Plan: Restrictions

Posted in Fee-For-Service Plans , Health Insurance

September 26th, 2009
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Freedom can be costly, especially when it comes to choosing a fee for service health insurance plan. Fee for service plans are also referred to as “traditional health insurance.” Policyholders of this type of health insurance can choose any doctor, hospital, surgeon or health practitioner of their liking. There are no restrictions associated with a fee for service health plan. Many other types of policies require individuals to choose a primary care physician to get referrals of any kind, but that is not the case with a fee for service health insurance plan.

High Premiums

The only restriction associated with a fee for service health insurance plan is that for the flexibility, the premiums associated with the plan are extremely costly. But for that additional expense you can choose to seek out any type of medical attention. It is important to note that with this type of policy, not only are the premiums higher, but all the other costs associated with a fee for service plan may be cost-restrictive to some.

Upfront Payments

With a fee for service plan, a member is responsible for paying their care providers out-of-pocket when visiting the doctor. Then the member must complete the proper paperwork to submit a claim, and then a deductible amount (that could be in the thousands) must be met. Once that is met, the benefit kicks in and the cost of the medical care will be shared between the insurance provider and the policyholder in a coinsurance agreement.

All the restrictions associated with fee for service health insurance plans are associated with the overall cost for these types of policies. If you are interested in a fee for service plan despite the cost restrictions, it is advisable to open a medical savings account in order to get some tax relief and have the extra money put aside so you can take advantage of this type of traditional health insurance.

How to Pick a Doctor for Your Fee-for-Service Plan

Posted in Fee-For-Service Plans , Health Insurance

September 21st, 2009
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One of the most important benefits an employer can provide their staff is the gift of medical insurance.

If you are self employed, it is imperative you that you allot a portion of your income to pay for this basic necessity as health insurance will not only protect your body but also diminish the negative affects the costs can have to your financial situation.

There are a large variety of health insurance plans to choose from. However, if you believe in “freedom of choice” then the best option would be opting into a fee-for-service plan for yourself and family. Although a fee-for-service plan is the most expensive type of medical insurance, members are allowed to select their own doctors. There is no service network in place requiring policyholders to use specific medical practitioners, the decision of what doctor to select for fee-for-service plans is solely at the discretion of the member.

With the entire world of physicians at your your disposal it is up to you to select your doctor for your fee for service plan.

Some tips that may help you narrow down your selection process are:

• To search for your doctor before you actually need their assistance as if an emergency does occur, you may have to just play the cards that are dealt to you as far as your tending physician
• Women need to select both a general practitioner and angynecologist
• Talk to your friends about who their health care professionals are as word of mouth is often a great way for discovering a doctor
• Investigate whether or not the doctor of choice is in good standing with state agencies that grant medical licenses to physicians
• Check out the physician onDocFinder
• Before scheduling an appointment with the doctor, feel free to conduct a phone interview with them to ensure that you are comfortable with both their experience and demeanor

FAQ: Do I Pay a Deductible for a Fee For Service?

Posted in Fee-For-Service Plans , Health Insurance

September 18th, 2009
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There are so many types of medical insurance plans to choose from that consumers need to weigh the pros and cons of all of them before committing to one option. One health insurance plan that may be right for you is a fee for service plan. Fee for service plans are the most flexible of all insurance plans as it provides policyholders the opportunity to choose any doctor. For the luxury of freedom, a fee for service plan tends to cost more to the insured in the form of higher monthly premiums, a greater financial responsibility in co-payments and the responsibility of paying a deductible for a fee for service plan.

Fee for Service Payments

When opting into a fee for service plan, a member will be alerted of the amount of money they are financially responsible for paying until their benefits kick in. That monetary figure is a deductible amount. The deductible amount varies from insurer to insurer and policy to policy, but can range anywhere from hundreds to thousands of dollars. Like with all insurance, policies that tend to have higher deductibles have slightly lower monthly premiums.

Deductibles

Until the deductible for a fee for service plan is met, the co-payment benefits of the insurance will not kick in for the member. It is important to note that not allhealth expenses count toward the deductible amount. It is important to review your insurance policy before seeking medical attention to ensure that the services rendered will apply to a deductible for a fee for service.

Fee for service plans typically have a cap involved limiting the amount of money a member will need to pay out of pocket. That dollar can range from $1,000-$5,000 annually and does not included the monthly premium. However, the amount that has been paid towards the deductible for a fee for service plan is included as part of that cap.

Self-Employed? How about a Fee for Service Plan?

Posted in Fee-For-Service Plans , Health Insurance , Indemnity Health Insurance

July 29th, 2009
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You love being your own boss as there is no need to explain why you’re late, among other perks. The only downside to being self-employed is being responsible for finding and paying your own medical insurance. The options are overwhelming, and choosing not only a cost efficient plan but one that will cover all your needs can be especially challenging. One option to consider is a fee for service plan for self-employed individuals.

A fee for service plan is a type of medical insurance policy that provides participants the freedom to choose whatever doctor they want to see as there is no managed-care network limiting the members choice. But for this type of flexibility, fee for service plans are the costliest medical insurance option. The premiums are higher as the rates that out-of-network physicians charge are at their discretion, deductibles in the thousands of dollars range need to be met before the co-payment benefits kick in, and then the insurance company will only reimburse the member for a portion of their medical expenses, typically about 80%. There are usually out-of-pocket caps that will limit the type of additional financial burden you will need to take on when enrolling in a fee for service plan for the self-employed.

Despite that, fee for service plans are a viable option for the self-employed demographic, especially if they travel for business. With a fee for service plan, the member can have the choice to seek medical attention in whatever area they are traveling to, and do not have to seek the permission of a managed-care provider.

Self-employed individuals seeking fee for service plans should know they are also called indemnity plans. This type of insurance offers the most flexibility for their members, but members are responsible for paying their fees up front, filling out their own claim forms, meeting their deductible, then waiting for reimbursement.

***Are you self-employed and looking for an affordable health insurance plan? If so, make sure you are comparison-shopping quotes to ensure you get the best deal possible. Go Insurance Rates makes it easy for you by providing you with multiple free health insurance rates from leading insurers in only a few minutes. Best of all, the service is easy, secure and 100% free.***

Fee for Service Basic Facts

Posted in Fee-For-Service Plans , Health Insurance

July 24th, 2009
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Medical insurance is a necessity for offsetting the trauma and expenses that can occur from an accident, disease or other debilitating medical situations. There are a variety of health care plans to choose from but if you like having the freedom of choice in selecting your own doctors, a fee for service medical plan may be to your liking. Of all the types of health insurance available to American consumers, the fee for service plan (also known as indemnity health insurance) provides members with the biggest degree of freedom as far as medical care selection as there is no service networks restricting you.

If you like the sound of absolute freedom with your doctor selection, then there are some other fee for service facts you need to consider before signing on the dotted line:

• Fee for service health insurance is the most expensive type of medical insurance for policy holders
• The premiums for fee for service health insurance is high because there is no service network that can control the costs of the medical treatment that consumers will be charged
• Fee for service health insurance members tend to need to meet a deductible (the amount varies) before their benefit co-payments kick in
• Typically insurers will pay a portion of 75%-80% for a members medical claims leaving the rest for the policyholder to pay out of pocket
• Those opting for fee for service health insurance are responsible for paying their medical expenses out of pocket and after meeting their deductible, they will be reimbursed
• Fee for service medical insurance is typically broken down to two parts: basic coverage that covers thecost of doctor visits, hospitalization, surgery, etc. and major medical that pays for the majority of the bills in case of serious illness or injury
• Fee for service health insurance will more than likely limit its coverage to “usual, customary and reasonable” treatment and fees
• Fee of service health insurance may also pay a predetermined amount with limits as described in the original policy terms

***If you have more questions about the different types of health insurance available to you, visit Go Insurance Rates for more information. The knowledge you acquire could help you save big on your health insurance rates.***

Advantages / Disadvantages of Fee For Service (FFS) Plans

Posted in Fee-For-Service Plans , Health Insurance

July 20th, 2009
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The world of medical insurance can be confusing to understand. The language includes terms like premiums, deductibles and co-payments. Having to decide exactly what type of health insurance option may benefit you can further complicate matters, and with so many options, it’s important to know all your choices before settling on one. One option is a fee for service plan, which also goes by the name of indemnity health insurance.

Fee for service plans are health insurance plans that allow their members the greatest degree of flexibility in their choices of medical providers including both doctors and hospitals. By opting into a plan of this type, a member can see whomever they chose as their primary health care provider and does not lock the member into a service network of providers.

Advantages of Fee for Service Plans

• The most flexible type of health insurance available to consumers
• Doctors can be seen wherever needed, including out of state for the insurance policy
• No waiting periods required for seeking the advice and consultation of a specialist

Disadvantages of Fee for Service Plans

• They have the most expensive premiums of all types of health insurance
• Deductible amounts must be met before co-payments kick in
• Insurance companies will not fully reimburse you for the cost of the services, and members are typically responsible for 20%-25% of their medical expenses
• Services must be paid for out of pocket by the member until they can be reimbursed
• Members are subject to completing their own claim forms and being responsible for all paperwork associated with their medical claims
• Little attention is provided to preventive medicine and care in fee for service plans

If you travel extensively, have a favorite doctor that you are committed to, or prefer flexibility, a fee for service plan may be for you.

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Getting Different Quote Ranges for the Same Carrier?

Posted in Compare Health Insurance , Fee-For-Service Plans , HMO , Health Insurance , Health Insurance Quotes , PPO , Point of Service Plans , Save on Health Insurance

April 22nd, 2009
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Health insurance is one of those things that individuals cannot go without. Sure, health insurance may cost thousands of dollars a year when you are in perfect health, and that may seem like thousands of dollars wasted. However, injury or disease can occur at any time, and without health insurance your financial situation can deteriorate quickly due to the overwhelming costs associated with medical expenses.

Choosing Basic Types of Health Insurance

There are many things to consider when researching health insurance. First, you may want to choose from one of four basic policy types including:

• HMO-Health Maintenance Organizations
• PPO- Preferred Provider Organizations
• POS- Point of Service Plans
• Fee for Service or traditional health insurance

Once you focus in on which type of coverage you want, you must then investigate which carrier you want. While analyzing the carrier, you may notice that you are getting different quote ranges for the same carrier. That is not unusual as within each carrier there are different tiers of service that will generate different quote ranges within the same health insurance carrier.

Different Offerings Will Cause Different Quote Ranges

When you are getting different quote ranges for the same health insurance carrier you need to review various aspects within the policy as they may cause price fluctuations. Different quote ranges for the same health insurance carrier will be influenced by:

• The annual deductible amount you will be responsible for paying; typically the higher the deductible, the lower the premium
• The out of pocket maximum limits your insurance will have
• Copayment or coinsurance amounts for office visits
• Hospitalization
• Drug costs
• Lifetime medical insurance maximums

Prices may fluctuate from plan to plan, even within a specific carrier. The different price tiers will cause fluctuations and differences in the price quote ranges you will get from the same carrier.

What is a FFS Plan?

Posted in Compare Health Insurance , Fee-For-Service Plans , Health Insurance , Point of Service Plans

April 13th, 2009
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When it comes to health insurance, there is a lot of confusion around the term fee for service and how it is different from other forms of managed care, such as an HMO or PPO. Basically, an FFS, or fee-for-service plan, is exactly what it sounds like: the doctor who treats you is paid a fee for each service rendered to you, the patient. This might seem self-evident, but in some kinds of managed health care plans, such as an HMO, doctors are part of a network and their participation in the health plan is prepaid.

Fee for Service Plan Basics

Fee-for-service plans generally allow you to go outside of the HMO network and contract with doctors and hospitals individually, paying a fee for service. For some patients, this is desirable as it offers you the maximum amount of freedom in choosing a physician. You can go to any doctor you want and change doctors whenever you wish. You still pay a premium, and you are still covered up to your deductible for basic protection and major medical, as long as your health care plan includes comprehensive care.

Disadvantages of Fee For Service Plans

There are a few drawbacks to using a fee-for-service plan that are unattractive to some consumers. Fee-for-service health care tends to be less predictable than staying within an HMO provider network. Your insurer pays only part of your doctor or hospital stay expenses, and you will be billed for the balance, including any requested lab work, or other procedures that are not necessarily covered by your insurance plan. You might also be required to fill out the claim forms yourself, if your doctors office is not within the insurers provider network. Some preventive health care visits, such as well-child care and routine immunizations, may not be covered under this plan. Be sure to check your policy and weigh the pros and cons before deciding on the best health insurance policy for you and your family.