HEALTH SAVER PLUS III offers all the freedom and cost savings of a traditional indemnity health insurance plan.
The PLUS is all policyholders can choose the services of MultiPlan / PHCS PPO Network of more than 900,000 healthcare providers (Doctors, Specialists, and Hospitals nationwide) at no additional cost.
The PLUS III is additional value-added services: preventive care benefits; ScriptSave; Teladoc; Karis360 – Healthcare Navigator, Karis Surgery Saver, Karis Bill Negotiator; and, Concierge Phone Service.
Traditional indemnity health insurance plans allow you to choose the doctor, healthcare professional, hospital or service provider of your choice and allow the greatest amount of flexibility and freedom in a health insurance plan. Also known as a “traditional indemnity plan” or a “fee-for-service plan” the plan helps provide protection against the costs of medical expenses. A key feature of the indemnity health insurance plan is that it does not force you to choose a primary care doctor.
The indemnity health policy is different than policies offered by health maintenance organizations (HMOs) and preferred provider organizations (PPOs) because it allows you to obtain medical care where you choose and then the indemnity health policy provides compensation for a set portion of the costs. In addition, indemnity health insurance plans are also unique because they allow you to self-refer to specialists, they do not require you to obtain a referral in order to get compensated if you choose to see a specialist.
Four Important Keys to Understanding an Indemnity Health Insurance Plan
If you have the opportunity to choose an indemnity policy for health insurance here are four important points to remember:
1. Indemnity Plans and the Usual, Customary and Reasonable (UCR) Rate
UCR rates are the amounts that medical service providers in your area usually charge for services because indemnity plans are self-managed health insurance plans there is no network specifying the rates that your chosen providers will charge. As a result, you will want to familiarize yourself with the costs that your plan designates as usual and customary versus what your chosen provider will charge for services to avoid unexpected costs. In particular, if you go to other geographic regions. In general most providers meet the criteria, however it is important to be informed when you use a self-managed plan like an indemnity health insurance plan.
2. You may have a deductible. The deductible is the amount you are required to pay before policy benefits are provided. If your health care charges are covered, or eligible for payment under the policy, your deductible will apply.
3. Indemnity Health Plans Do Not Restrict Access Based on Geographic Location As explained in our definition of the indemnity health plan above, in an indemnity plan, you have the freedom to choose your doctor, specialist, or hospital with few, if any limitations.
In some cases, HMO and PPO’s may limit your options for a doctor, specialist, or hospital by geographic restriction, or area in which the provider is located. This gives a significant advantage to the freedom offered by an indemnity plan for many people.
4. Indemnity Plans and Preventative Health Care Services Some Indemnity Health Insurance plans may not cover preventative services, while others do. Preventative health care services include yearly check-up exams and other routine office visits that are designed to prevent illnesses. Before selecting a health plan, be sure and discuss how preventative services are insured, and how much compensation you can expect. This will help you make the choice for the best possible plan. In some cases, costs of these services may not count towards your deductible.
- Access to Specialists With Indemnity Health Insurance Plans provide the ability to self-refer to a specialist can be a significant advantage in obtaining the best health care and is easily one of the greatest advantages with indemnity health care insurance plans.