Guide to Insurance

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Managed Care And Indemnity Plans: Finally Explained!

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Managed care plans have pre-existing service contracts that they have entered into with specific hospitals, health care providers, and doctors. A managed care plan will mean less paper work for you and much lower out of pocket expenses. There are 3 types of managed care programs available.



The PPO (or preferred provider organization) combines managed and indemnity to come up with its own flavor. You can choose from professionals in the PPO network or outside the network. If you choose outside the network you simply pay the bill and then submit for reimbursement. If you choose a PPO doctor, you will pay a nominal flat fee for service.

HMO (or health maintenance organization) requires you to pay when you see an HMO doctor, but there is no plan deductible. HMO will give you a list of doctors to help you choose a primary doctor.

Indemnity plans have no predefined contracts and can therefore offer a wider choice among health care professionals. They will probably cost you more, however. You normally pay the bill up front and then submit a claim. Deductibles often begin at around $200.00 and may go higher. Plans vary in coverage but usually cover about 80% of the final bill.

Over the years these two types of plans have actually begun to blur. In fact some indemnity plans are beginning to look more like managed care plans.

Be sure to comparison shop using one of the online services offering instant health insurance quotes. These services, sometimes offered at no charge, will have you complete a single, brief form allowing you to receive multiple quotes from insurance agents local to you. Using the information you provide on the form, you and your family members who will be covered by the policy will be evaluated and your risk assessed. This will determine your premiums and any restrictions your policy might have.

Whatever form of health insurance you eventually settle upon will most likely depend on your specific health care needs and those of your family. By doing a little research to understand the different kinds that are available, you will be much better armed to make an informed choice that make sense for your situation.
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