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Fee-for-Service Health Plans
A Fee-for-Service plan is a traditional health insurance arrangement in which the patient uses any doctor or facility of his or her choosing, and pays that provider directly. After payment is made, the patient then submits a claim to the insurance company. These types of plans are usually more expensive than HMOs or PPOs, but they allow the most freedom of choice.
The Fee-for-Service plan offers the same coverage throughout the country and, often, internationally. With this plan, the insured does not have to worry about finding an in-network doctor or facility.
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Advantages of a Fee-for-Service Health Plan
Offers the maximum freedom of choice for doctors, hospitals, and pharmacies
No referrals are necessary
There is maximum choice of specialists
The deductible may be low
Disadvantages of a Fee-for-Service Health Plan
Payment may need to be made up-front
All medical claims will have to be submitted in order to be reimbursed. All receipts would have to be kept, with copies filed at the time claims are filed. Some doctors will file for you, but you may need to take care of this chore yourself.
You will still need to pay co-insurance after your deductible is met.
This type of plan is more expensive than the others
Preventive care may not be covered, unlike other plans. The expenses for this type of care would be included when you meet your deductible.
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Fee-for-Service Plan Details
The focus of a Fee-for-Service plan is to allow maximum freedom of selection while providing coverage above a set cap. You need to be able to pay the deductible and co-insurance (or the agreed percentage of expenses above the deductible) out of your own funds. Most plans cover 70 to 80 percent of the expenses above the deductible.
Young, healthy people who don’t often get sick and rarely meet their deductible would be able to take advantage of this plan. This type of plan may also be ideal for business people who travel a great deal and need coverage no matter where they are. It might not be the best choice for families with young children, who need frequent doctor visits and a higher level of preventive care. It is also not the best choice for someone who would find the extra paperwork difficult.
Different varieties of these plans include basic coverage, major medical, and comprehensive plans (which include both basic and major medical coverage).
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