Major Medical.

So you went looking for a Major Medical Insurance policy so you could save some money.  A Major Medical usually has a deductible, which is higher than standard insurance and a coinsurance payment.
So a Major Medical plan with a $500 deductible with an 80/20 coinsurance, you pay the first $500 likely yearly deductible and then 20 percent of the remainder while the insurance pays the rest. Then you realize you want to have the freedom to choose the doctor you want and the place you want to be treated. A standard “Fee for Service” or FFS for discount health insurance can be among the most expensive policies however.

What is FFS?

When you have a FFS, the insurance company pays a certain amount for each individual service you get after you pay the deductible. Services like an X-ray, a shot, and the visit with the doctor are billed separately. The insurance company will pay what they think it’s worth, which may not match what is billed. They use a UCR and or a fixed schedule.  A UCR is what they call a “usual, customary, and reasonable charges”. They pay for what they call “medically necessary” procedures”.  Also, if your doctor bill is higher than what the insurance company pays, you pay the difference. A fixed schedule has a table of what they will pay for every procedure. 

FFS has the basic same attributes as Major Medical in that it does have a yearly deductible and coinsurance payment.  The deductible is usually fairly low, but your premiums are quite high.  Some plans require you to pay the provider up front and then get a portion reimbursed by the insurance company.  Others will do the billing directly with the provider and send the remainder to you.  Also, providers also will sometimes do the billing for you. 

How can I save money?

So you love the freedom to choose your doctor and your location, but you don’t love the high premium. Can you still get discount health insurance?  Sure you can. The first thing you can do is raise your deductible so that it is higher like a Major Medical policy.  You can also do other things like have a MSA or Medical Savings Account. Since you are planning on frequent visits to the doctor, you might as well set aside money for it pre-tax.

So who would like an FFS the most?  Probably someone who goes to the doctor frequently, can afford a high deductible, and absolutely needs freedom to choose their doctor and location. Experts is the industry highly suggest that you obtain a minimum of three free online quotes.