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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 ?
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.
Sterling Life Insurance Company, has been approved by the Health Care Financing Administration (HCFA) to offer the nation's first Medicare+Choice Private Fee For Service Plan (PFFS).
Private Fee For Service Plans were authorized under the Balanced Budget Act of 1997.
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.
The MDI capitated contract presently generates revenue of approximately $45,000 per month, exclusive of MRI, bone densitometry and OB ultrasound, which are billed on a fee for services basis.
If successful, these new fee for service contracts should turn around the company's fee for service income, which has been falling in the first nine months of 1997 due to the loss of a substantial contract with the Florida Residential Property JUA effective July 1, 1996.
21, 1998--Abele Owners' Network, America's original and largest Internet registry and information service of homes for sale by owner, today announced its partnership with Help-U-Sell, the original and largest fee for services rendered real estate franchise in North America.