Indemnity plan

Health insurance plan in which the insured pays 100% of all medical bills until he or she reaches the annual deductible and then the insurance company pays a percentage of covered benefits up to a maximum amount. Most indemnity plans pay 80% of total charges, leaving policyholders with a 20% coinsurance. The insured may obtain care from any health care provider and the provider is paid each time a service is rendered on a fee-for-service basis. The insured pays a fixed monthly premium, but these plans are more expensive than a managed care plan. These plans often provide coverage only for medically necessary doctor visits and not preventive care. A “pure” indemnity plan has no controls on utilization or price; a “managed” indemnity plan incorporates some utilization review and case management. Schedule of allowances, table of allowances, and usual, customary, and reasonable (UCR) are examples of indemnity plan fee schedules. Also known as indemnity insurance, conventional group insurance , and traditional insurance .

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