Health Care and Health Care Plans « Allied Health World Blog

Health Care and Health Care Plans

There are three general types of health insurance policies. Each category has different allowances for health care.

Managed care plans:

These types of care plans focus primarily on maintaining good health and finding ways of lowering the risk of developing more severe and costly illnesses. The insured must choose from a list of approved healthcare providers. Medical care received from an unapproved provider will not be reimbursed. This is because managed care plans make make prearranged fee agreements with certain physicians. There is usually no deductible and preventive care such as physician examinations and vaccinations are often covered.

Indemnity healthcare plans:

These types of care plans focus on treating current illnesses and are not likely to be preapproved for preexisting conditions. The insured person has the opportunity to choose the healthcare provider. However, the insured person must be willing and able to pay out-of-pocket for all medical expenses and then submit a claim for reimbursement to the medical insurance company. Preventive care, such as physician examinations and vaccinations may not be covered.

Combined plans:

Combined plans offer the best of both managed care and indemnity healthcare plans.These types of care plans are favored because they combine the feature of the two other plans. For example, a combined plan allows the insured to choose treatment from an approved or unapproved healthcare provider. There is incentive to choose an approved provider because the insurance company offers to pay a greater portion of the medical costs. However, you still have the option of receiving treatment from an unapproved healthcare provider. The only downside of doing this is that the insurance company will pay a smaller portion of the medical cost leaving a greater portion of the cost to the insured person.