Learn Some of the Technical Terms Used to Describe Health Insurance Plans
Part 1: The Basic Tools, Chapter 2: Understanding the Language of Health Insurance Page 12
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Table 6 - Technical Terms Used to Describe Health Insurance Plans
Type of Insurance Plan |
Description |
| Traditional Plan (Indemnity Plan, Fee-for-Service Plan) | A plan in which the consumer chooses the doctor, laboratory, testing center, or hospital, pays the bill, and sends the claim to the in surer for reimbursement |
| Managed Care Plan | A plan such as an HMO or PPO in which participants must generally use medical providers that are part of the plan network in order to obtain maximum benefits |
| HMO with POS Option | A managed care plan that allows participants to occasionally consult out-of-network providers and still obtain partial reimbursement |
| Self-funded Plan | A plan established by a corporation, by a union or association for its members, or by a state or municipal government agency; if an insurer is involved, the insurer acts as plan administrator |
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