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Traditional insurance coverage, which is more formally known as Fee-For-Service or FFS is a form of medical coverage that varies quite a bit from HMO or PPO. While HMO and PPO plans are both managed care policies, the traditional medical plan is not.
If you have a traditional health plan, you can choose any medical provider that you wish. Whereas an HMO restricts you to working only with medical experts within a specific network of providers and a PPO provides less coverage when you go outside of your network, a traditional medical care policy does not restrict where you can go for medical services.
When you have a traditional health plans, you may have to pay for the medical expenses upfront after being billed by the medical facility. After paying the bill, you can submit the bill to the company and get reimbursed for the amount that you have been required to pay. This is because the company does not have a contract with the medical provider.
In most cases, this type of policy does not pay 100% of the costs associated with medical care. Rather, the proider will have a pre-determined If “Allowable Amount” for various services that are covered by the policy. In this case, the company will only pay up to the allowable amount and you are then responsible for paying the difference. This Allowable Amount is typically figured by determining the “Usual and Customary Charge” that providers in the same geographical area charge.
If you are not required to pay your bills and wait for reimbursement, the medical provider will send your bill to your provider. The provider will then pay the Allowable Amount and you will be responsible for paying the balance. In this case, you will receive what is known as “Balance Billing.” If the company does have a contract with the provider, however, you might not be responsible for the balance of the cost. For this reason, it is a good idea to find out ahead of time whether or not the provider charges only the Allowable Amount or expects you to pay the balance.
Even when the medical provider only bills the Allowable Amount, this type may not pay the full cost. This is because it may require to pay a deductible as well as coinsurance.
Since there are so many different variables that can affect this type and the amount of money you are expected to pay, it is important to look at these policies carefully before making a purchase. Consider how much of the costs are covered as well as how the payment is made. If you are not in the position to pay the costs ahead of time and to wait for reimbursement, for example, you might need to look strictly at policies that pay the expenses and only require you to pay the leftover costs.
Keep in mind when you shop around for this type of healthcare coverage that the amount of your deductible and co-insurance will have an impact on your premium costs. In general, the less expensive these costs, the more you can expect to pay in premiums.
If you are interested in obtaining traditional medical coverage, take a few moments to fill out our online form. The form can be completed in a matter of minutes and it will put you in touch with a number of providers that can offer you the type of insurance coverage you desire. Rather than going to them, let the insurance companies come to you.