This valuable resource includes listings of participating fee-for-service plans
, health maintenance organizations, and point-of-service plans.
With the birth of their first child, Christopher, 16 years ago, Guelda and Cornell Slade of Houston had a traditional fee-for-service plan
. Upon the birth of their second child, Courtney, two years later, the couple had switched to a straight HMO.
So, if you choose a fee-for-service plan
, you pay that full increment.
Federal employees often cite customer service when explaining their reasons for staying with a plan, especially when they are enrollees in a fee-for-service plan
Most employees are familiar with fee-for-service plans
, the prevailing benefit offering for years.
It might be expected that those patients who had recently enrolled in the capitated plan would have scheduled a health maintenance visit when starting in the new system, whereas those enrolled for a longer period in a fee-for-service plan
might have been less inclined to make a health maintenance visit within the specified period studied.
This leads to the following hypothesis: an individual's decision to enroll in an HMO or a fee-for-service plan
will be influenced by that individual's perceived health risk ("personal vulnerability") as well as by his or her perceived financial risk.
Several Medicare Advantage fee-for-service plan
sponsors have agreed to voluntarily suspend marketing of their plans until officials at the Centers for Medicare and Medicaid Services can verify that they are in compliance with certain management controls.
The only controlled study found about a 20-percent difference in hospital admission rates and close to a 40-percent reduction in hospital days when populations were randomly assigned to a group HMO and a fee-for-service plan
with 25-percent copayments (Manning, Leibowitz, Goldberg, et al., 1984).
However, when middle-income retirees are free voluntarily to add their own money on top of the government contribution, through a private fee-for-service plan
, they stop being the beneficiaries of cost-shifting and become contributors to it.
Co-insurance: The amount, or percentage, you pay for medical care in a fee-for-service plan
after you have met your deductible.
In that case, a depressed patient who switched from a fee-for-service plan
to a prepaid plan is estimated to have only about 2/3 of the service use that a similar patient would have who has been in the prepaid sector for a longer time (six actual visits versus nine predicted visits; see Table 3), whereas a new fee-for-service patient uses 11 percent more services than a fee-for-service stayer.