Fee-For-Service Plan

  • Health insurance which offers the patient their choice of doctors and hospitals
  • Insurer only pays for part of the bill
  • Patient pays a monthly premium and a yearly deductible
  • Patient is responsible for keeping track of medical expenses and claims

Questions to Ask About Fee-for Service Insurance

  • What does the policy cover?  Does it cover prescription drugs, out-of hospital care, or home care?  
  • Are there limits on the amount or the number of days the company will pay for these services?
  • If currently being treated for a medical condition, will that be covered under this plan?  
  • Are there limitations or a waiting period involved in the coverage?  
  • What is the deductible?  (With a higher yearly deductible you may be able to lower your monthly health insurance premium.)
  • What is the coinsurance rate?  
  • What percent of your bills for allowable services will you have to pay?
  • What is the maximum a patient would have to pay out of pocket per year?  
  • How much would it cost the patient directly before the insurance company would pay for everything else?
  • Is there a lifetime cap (maximum amount) that the insurer will pay?