Out of Pocket Maximum for Indemnity Health Plans

Choosing a health insurance plan can be confusing as there are not only a slew of policy options to choose from but the range of providers can also seem endless. If however, you have decided that an indemnity health insurance plan is right for you, there is some basic information to consider before signing the contract with the insurance provider.

Indemnity Plan Basics

Indemnity health insurance plans offer their members the most flexible type of health coverage out there. With an indemnity health insurance policy, consumers are not beholden to any service network, meaning there are endless medical practitioners to choose from. Because of the flexibility and freedom of choice that comes with an indemnity health insurance plan, the premiums tend to be more costly than medical insurance that requires patients to seek in-network care. The good news is that the out of pocket maximum members need to pay for their own care under an indemnity health insurance plan is capped.

Out of Pocket Basics

Insurance providers need to hedge their losses by finding different revenue streams from members to offset the overall expenses of provided medical coverage on a plan. One such tactic is requiring an out of pocket maximum for indemnity health insurance plans for the policyholder. Ultimately, the holder will have to pay a portion of the medical bills and the insurance will cover the rest.

An out of pocket maximum is the most your insurance provider will allow you to pay yourself – they will have to cover the rest. The actually dollar amount of the out of pocket maximum for an indemnity health insurance plan differs based on the amount of premiums a consumer pays for the coverage. Typically, higher premium costs means lower financial requirements are needed to meet the out of pocket maximum for an indemnity health insurance policy.

Only your specific health insurance provider can tell you exactly how much the cost will be for you to meet the out of pocket maximum for your indemnity health insurance policy. Typically, the range for an out of pocket maximum can be fromfrom $1,000 to $5,000, but you must check with your insurance provider to ensure you know the specifics to their policy.