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Fee-For-Service Health Insurance

Understanding health insurance - What does fee-for-service mean?

The term fee-for-service refers to the way doctors are paid, regardless of who pays. Traditional health insurance - what insurance companies call indemnity coverage - is a fee-for-service arrangement. Paying cash for medical treatment is a fee-for-service arrangement.

With fee-for-service health insurance, you choose the doctor you want to see. After you have received treatment you or your doctor submits a claim to the insurance company for reimbursement. You will only receive reimbursement for the covered medical expenses that are included in your health plan.

Most policies have an out-of-pocket maximum. This means that when your covered expenses reach a certain amount in a given calendar year, a reasonable fee for the benefits that are covered on your insurance plan will be paid in full by your insurer and there will no longer be a need to pay the co-insurance.

What does Managed Care mean?




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