What is the main feature of a fee for service medical expense plan?

What is the main feature of a fee for service medical expense plan?

• A. The insured pays a flat premium for all services
• B. Insurance covers all medical expenses with no deductible
• C. The insured pays for each service individually
• D. Insurance is not required for medical bills

Answer: (C)

The primary characteristic of a fee-for-service medical expense plan is that the insured pays for each service individually. This type of plan allows patients to select their healthcare providers and pay them directly for each medical service rendered, such as doctor visits, hospital stays, or diagnostic tests. Once the insured receives a medical service, they then submit a claim to the insurance company for reimbursement based on the terms of their policy. This system promotes a higher level of choice and flexibility for the patient in managing their healthcare, as they can seek out specialists and initiate services they deem necessary. However, it is important to note that the insured assumes more upfront costs, which they recoup through their insurance plan later. The incorrect options highlight different aspects of healthcare insurance offerings. A flat premium for all services suggests a prepaid system, typically associated with capitation arrangements rather than fee-for-service. The idea of insurance covering all medical expenses with no deducible indicates a comprehensive coverage plan, which is not a feature of fee-for-service setups, as these usually involve deductibles and out-of-pocket expenses. Lastly, asserting that insurance is not required for medical bills implies a lack of the insurance component altogether, which does not pertain to fee-for-service plans that still operate within a structured

The primary characteristic of a fee-for-service medical expense plan is that the insured pays for each service individually. This type of plan allows patients to select their healthcare providers and pay them directly for each medical service rendered, such as doctor visits, hospital stays, or diagnostic tests. Once the insured receives a medical service, they then submit a claim to the insurance company for reimbursement based on the terms of their policy.

This system promotes a higher level of choice and flexibility for the patient in managing their healthcare, as they can seek out specialists and initiate services they deem necessary. However, it is important to note that the insured assumes more upfront costs, which they recoup through their insurance plan later.

The incorrect options highlight different aspects of healthcare insurance offerings. A flat premium for all services suggests a prepaid system, typically associated with capitation arrangements rather than fee-for-service. The idea of insurance covering all medical expenses with no deducible indicates a comprehensive coverage plan, which is not a feature of fee-for-service setups, as these usually involve deductibles and out-of-pocket expenses. Lastly, asserting that insurance is not required for medical bills implies a lack of the insurance component altogether, which does not pertain to fee-for-service plans that still operate within a structured