Health insurance helps protect you from the high cost of medical care. Many people in the United States get health insurance through their employer. In most cases, the employer helps pay for the insurance. Insurance through employers is often with a managed care plan. These plans contract with health care providers and medical facilities to provide care for members at reduced costs.
You also can purchase their own health insurance. Usually cost you more than employer-based insurance. People who meet certain requirements can qualify for government health insurance, like Medicare and Medicaid. If you do not have health insurance, you must pay your medical bills directly or rely on healthcare providers or organizations that donate to care.
Health insurance plans are usually described as either indemnity (fee-for-service) or managed care. Types of plans differ in important ways described below. With health plans, however, there is the basic premium, which is how much you or your employer pay, usually monthly, to buy health insurance coverage. In addition, there are often other payments you must make, which will vary by plan. In considering any plan, you should try to know the total cost to you and your family, especially if someone in the family has a chronic health condition or serious.
Indemnity and managed care plans differ in their basic approach. Enter the area, the main differences concern choice of providers, out-of-pocket costs for covered services, and how bills are paid. Usually, indemnity plans offer more choice of doctors (including specialists such as cardiologists and surgeons), hospitals, and other health care providers than managed care plans. Indemnity plans pay their share of the cost of services only after they receive the bill.
Managed care plans have agreements with certain doctors, hospitals, and health care providers to provide various services to plan members at reduced cost. In general, you will have fewer documents and lower out-of-pocket costs if you select the type of managed care plans and a wider choice of health care provider if you choose a plan-type compensation.
Over time, differences between types of plans have begun to blur as health plans compete for your business. Some indemnity plans offer managed care-type options, and some managed care plans offer members the opportunity to use a provider that is "outside" the plan. This makes it even more important for you to understand how your health plan works.
