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A form of health insurance where the policyholder pays for medical expenses out-of-pocket and receives a reimbursement from the insurer. That is, a fee-for-service plan reduces the insurer's risk that the plan might be abused by requiring the policyholder to pay for expenses first, and only reimburses him/her afterward. Generally speaking, a fee-for-service policy includes some co-insurance. Some medical practices require fee-for-service payment to reduce the risk that it cannot perform a procedure if the insurer denies coverage. That is, the practice expects the patient to pay when the service is given and to file with the insurer for reimbursement afterward.


When you're covered by fee-for-service health insurance, you pay your medical bills and file a claim for reimbursement from your insurance company.

Most fee-for-service plans pay a percentage -- often 70% to 80% -- of the amount they allow for each office visit or medical treatment. You pay the balance of the approved charge plus any amount that exceeds the approved charge.

Your share of the approved charge is called coinsurance.

If you are enrolled in Original Medicare, which is a fee-for-service plan, your healthcare provider will file the insurance claim on your behalf.

References in periodicals archive ?
Private Fee For Service Plans were authorized under the Balanced Budget Act of 1997.
We have made a strategic commitment to develop our fee for service business and are excited that we have now entered this marketplace" said J.
Based on MDI's success in securing nearly one half of Aetna's population in Monmouth County, it is estimated that Bloomfield Diagnostic Imaging will enroll over 150 physicians and approximately 60,000 Aetna members; accordingly, these referrals could generate $90,000+ per month or over $1 million per year in revenues at this facility, plus the fee for service revenues.
7, 1997--An important part of the company's earnings base is the fee for service business established four years ago.
In a fee for service system, doctors are paid every time they provide a service, so some may have the incentive to do more than what could be considered medically necessary in the delivery of patient care.
Consumers calling the 1-800-874-5662 number talk to trained insurance professionals rather than telephone operators unfamiliar with insurance issues, according to Keith Maurer, president of Fee For Service.
NOTE TO EDITORS: For comparisons with existing traditional disability policies, or more information about this new policy or Fee For Service, call contact below/
NYSE: HUM) and State Farm, the nation's largest property and casualty insurer, announced today that the more than 17,000 State Farm agents will have the opportunity to be licensed to sell Humana's Medicare Advantage private fee for service (PFFS) plans for 2007.
Under fee for service, once a clinical transaction occurs and financial accounts for it are settled, neither provider nor payer has a financial incentive to incur the costs of maintaining electronic records of the transaction.
Once that occurs, the bill calls for disease management to be integrated into the Medicare fee for service program.