Traditional indemnity health insurance commercial insurance carriers
Basic insurance
Covers a specific dollar amount for physicians fees hospital care surgery and anesthesia
Blue cross
Covers hospitalization radiology and other basic coverage under the health plan
Blue shield
Covers the major medical portion and physician fees
Capitated plan
A managed care group makes a fixed per capita payment periodically to a medical service provider such as a physician in return for medical care provided to enrolled individuals
Medical insurers types of coverage
Basic insurance or major medical insurance
Indemnity plan
Blue cross blue shield but they also offer several capitated prepaid health plans that feature managed benefits and managed care options
Major medical coverage
Designed to cover some of the costs of catastrophic expenses from illness or injury
Traditional indemnity insurance policy
Includes coverage on a fee for service basis this method of reimbursement the insurer pays the provider a fee based on the cost of service
Employer sponsored plans
Offer group coverage
Individual
People who buy insurance on their own receive individual coverage may extend to family members as well
Patient
Responsible for paying a deductible and a coinsurance amount bills are submitted to the insurance company and if the annual is met the coinsurance is applied to the difference payment made to insurance to physician or both
Blue shield blue cross
Well known type of traditional insurance a nonprofit organization providing basic and major medical coverage