Fee for Service- The fee for service insurance plan doesn’t have any known restrictions however, the plan does allow you to have the flexibility of which doctors you want to see, and where you want to get medical services but in the long run the premiums are very costly which isn’t beneficial for this kind of insurance plan to utilize. (Fee for Service Plan: Restrictions)
Managed Care Plans Having a managed care plan has its perks but also has disadvantages associated with it. If you do have a managed care plan, one of the disadvantages of the plan are that you may not be able to see your physician if they are out of network. Most managed care plans place restrictions on their patients to where they can receive care through the providers that are established with the managed care plan. If a patient wants to see a doctor of their choice, that may be out of network then the patient would need to pay for those services out of pocket. Also with a managed care plan there is a “lifetime cap” that is the allowed benefits that a patient can receive during their lifetime. If a patient reaches that cap, then there is no additional coverage through the plan and all the expenses would need to be paid out of pocket by the patient. (Benefits & Disadvantages of Managed Health Care)
Medicare Medicare does have specific restrictions within the
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This program was implemented for uninsured children under the age of 19, are U.S. citizen, a U.S. national or qualified alien and must not be covered under any other insurance plan whether its self-insured or self-funded. CHIP is based from family size, and income, and each state has its own chart to determine family size, income, age of children, to properly meet the requirements for the program. CHIP was created for those who do not meet the requirements of being eligible for Medicaid due to incomes.