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