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Home » Business And Finance Articles » Indemnity Health Insurance What It Means To You

Indemnity Health Insurance - What It Means To You

At first glance, an indemnity health insurance plan may seem to hand policy holders the short end of the stick. After all, this type of insurance tends to pay less toward health care claims than a managed-care plan. Additionally, the policy holder generally pays more out-of-pocket and has to deal with more paperwork when it comes time to file a claim.

However, for a great number of people, indemnity is the undeniable way to go. Individuals may choose indemnity plans because they have favored health care providers who are not part of a managed-care network, or because they travel a lot and need the flexibility to seek care away from home, or for any number of other reasons. What makes an indemnity plan the right choice is different from one consumer to the next.

What primarily separates an indemnity plan from a managed-care plan is the presence or absence of a provider network. A managed-care plan comes with a network of health care providers who have arranged with the insurance company to provide their services at an agreed-upon rate. This allows the insurance company to know how much to expect to pay for any given service. It also allows the provider to know to some extent which services will be covered and the corresponding level of coverage. Because the insurance company has made prior arrangements with these providers, paperwork can be filed directly between the provider and the insurance company. The insurance company pays the provider directly for care, requiring the policy holder to pay only a small percentage of coinsurance or minimal co-pay amount out-of-pocket.

With an indemnity plan, on the other hand, there is no network of pre-approved providers. This means the insurance company is taking a greater risk when it comes to a policy holder's choices of health care providers. The policy holder may choose a provider that charges more than the insurance company expected to pay for a particular service.

For this and other reasons, insurance companies offering indemnity plans give themselves some protection from the choices their policy holders may make. They typically charge a higher annual deductible that must be met before coverage begins. They often require policy holders to pay the full cost for the service out-of-pocket and then to file the paperwork of the claim themselves to seek reimbursement for the care. This protects the insurance company from paying for services that are not covered under their plans and also from paying more than what is reasonable for the care their policy holders are claiming. The insurance company may determine a reasonable charge for a service by referring to a table of UCR (usual, customary, and reasonable) figures determined by the average cost billed by providers in a particular area.

An indemnity plan may sound like a poor choice for a consumer to make, but for the reasons mentioned earlier as well as others, an indemnity plan can be the best choice for some consumers. An indemnity plan does not require its policy holders to choose a primary care physician (PCP) or obtain a referral to receive care. In this way, it's one of the easiest plans to use. Policy holders seek their health care whenever and from whomever they choose.

Deciding between an indemnity and a managed-care plan is an individual choice. Like all decisions pertaining to health care and health insurance, the options should be thoroughly researched and carefully considered. Under the right circumstances, an indemnity plan can offer the greatest flexibility in obtaining health care and provide its policy holders the opportunity to be in maximum control of their health care choices.

And here is another random article you might be interested in...

Adverse Credit – We've All Heard Of It, But What Does It Mean?

If you're one of those lucky people who have never missed a single credit card or loan repayment, then you don't need to worry about the term 'adverse credit'. In this article, we are discussing the ins and outs of the term 'adverse credit', something that describes people who have defaulted on credit repayments to a significant extent. The terms 'sub-prime and 'poor credit' are also used to describe the same situation. What we are here to ascertain is: what do you have to do to be called an adverse credit customer, and where does the lender get their information about you?

To start off, we will discuss the credit reference agencies, companies such as Experian and Equifax who collect and store information about all your financial dealings, and sell this information to lenders. Other parties that can see your credit history are insurance companies, banks, landlords, government agencies and employers, they are allowed, by law, to see your past financial details.

They know a lot about you, you may be surprised at just how much. Apart from the obvious (your name, date of birth, social security details), they also have your addresses (past and present), records of all the jobs you have had and with who, your entry on the voter's roll, your mortgage, credit card, loan and hire purchase details, records of any unpaid County Court judgements, and most surprisingly, details on all the loan and credit card applications you have ever made.

So where do the credit agencies get their information from? They get it from the Public Records offices and the financial institutions themselves â€" banks, credit card companies etc. Once you've got a bank account, you're on the computer records and the credit agencies start collecting information about you.

Experian, Equifax and the other agencies also offer another service to the lenders, they have the facility to give you a credit score, using the lender's own criteria to score your eligibility for credit. If you don't score high enough, you may not get the credit you have requested, which is why your credit score is so important. The credit score works by matching your financial details against different criteria. You could score well for having met all your credit card repayments for example, but score badly because you have moved address or employer a number of times. In any case, the higher score, the more likely you will get the credit you asked for.

The eventual credit score is providing an estimate on your eligibility to receive the credit, making the general assumption that your future repayment habits will be the same as your past. As extra insurance, they also compare your information with other applicants with similar characteristics as you, to see how they fared. In the end, the decision whether you can be offered credit is automated, and based on statistical analysis. If your score is close to the pass level, then the lender may choose to offer you a lower level of credit, or a higher interest rate.

All the lenders have different ideas about what is and isn't acceptable, and some will refuse your application without giving you a reason why. It's their decision, and it is not up to the credit reference agencies, they merely collate the information in the first place. It is the lender who gives you the label of 'adverse credit' customer.

We have collated here a list (in no particular order) of the situations that will, either alone or with others, make it difficult for you get to credit with a lender: if you're behind on payments for a loan, credit card or mortgage, if you have made a few late payments on the above, outstanding and unpaid County Court or High Court Judgements, if you are not on the electoral roll at the address you gave on your application form, and if you have made more than a usual number of loans and credit card applications. Two situations would normally result in automatic refusal: having had your home repossessed, and recent bankruptcy.

If you are aware of any of the aforementioned problems in your recent credit history, then don't be surprised if your application for credit is turned down, especially by the big, mainstream lenders. Some of the mainstream lenders are a bit more forgiving about mortgages, especially if you already have a mortgage and are meeting your repayments.

This article should contain most of the information you need to know about 'adverse credit', and help you understand what the lenders consider to be a bad risk, and why. If the worst happens, and you find yourself unable to get credit because of an adverse credit history, then you will probably have to seek credit from a sub prime lender. If you fit their criteria, they will offer you credit, but it will be more expensive.

The most important thing to remember is: always keep up do your loan, credit card and mortgage repayments, don't pay late or even more importantly, don't build up arrears. The financial consequences of getting behind could be both extensive, and expensive.