Health Insurance Basics & Policies

A traditional plan that reimburses providers per service, letting the insured choose any provider.

They may use any doctor or hospital and the plan pays a portion of usual, customary, and reasonable charges.

A managed-care plan providing comprehensive prepaid services through a network for a fixed periodic fee.

The primary care physician coordinates all care and must authorize referrals to specialists.

A fixed per-member payment to providers each period regardless of services used.

The defined geographic region in which the HMO provides covered benefits to members.