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Medical care coverage

A type of insurance coverage that provides for the payment of benefits as a result of sickness or injury. Medical care coverage can be provided in a hospital or a doctor's office. There are two main types of medical care plans. An indemnity plan—also called a fee-for-service plan—reimburses the patient or the provider as expenses are incurred. The most common type of indemnity plan is a preferred provider organisation (PPO). A PPO provides coverage to the enrollee through a network of selected health care providers (such as hospitals and physicians). Enrollees may go outside the network, but would incur higher costs in the form of higher deductibles and higher coinsurance rates than if they stayed within the network. The second type of medical care plan is called a prepaid plan—also called a health maintenance organization. A prepaid plan assumes both the financial risks associated with providing comprehensive medical services and the responsibility for health care delivery in a particular geographic area, usually in return for a fixed prepaid fee from its members.

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