Limited Medical Benefit Plans Vs. Mini Medical Plans

By Author: HDS Insurance Services
Total Articles: 4
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There are many different names for Limited Medical Benefit Plans. Many people mistakenly believe there is a difference between these types of names, when they are all really the same. Basically the industry started out calling these types of plans Limited Medical Benefit Plans, but after several years, certain marketers of these plans tried to get creative and started calling them by Limited Medical Benefit Plans, and tried to say that Limited Medical Benefit Plans offered a more comprehensive benefit than a mini-medical plan even though the plan design had not changed. Since then other marketers have made changes to the name to try to get creative to differentiate their limited medical program, by calling it a Limited Medical Benefit Plans plan or program or by some other name. Either way all of these Limited Medical Benefit Plans describe the same thing, a low cost affordable health plan that does not provide coverage for catastrophic medical expenses.

Limited Medical Benefit Plans offer a viable low cost alternative to expensive, comprehensive major medical insurance. Limited Medical Benefit Plans are scaled down ...
... versions of major medical plans. They can be offered to employers and also to individuals through association Limited Medical Benefit Plans. Such plan designs may be used as either primary insurance or supplemental (gap) coverage. Unlike comprehensive major medical insurance many limited medical plan designs do not base their benefits on actual charges incurred and actually pay based on a fixed benefit indemnity amount when various health care services are utilized. There are some expense incurred “copay” plans that do pay based on actual expenses incurred and do not pay based on indemnity benefits.

Copay Limited Medical Benefit Plans , provide copays and deductibles and coinsurance similar to a major medical plan but have “caps” on benefits and annual maximums, while indemnity Limited Medical Benefit Plans have no copays, deductibles or coinsurance.

Limited Medical Benefit Plans vary widely with some having an assignment of benefits, where the provider bills the insurance company directly, to requiring members to pay everything up front and then fill out a claim form and request their benefit. Limited Medical Benefit Plans also range widely in their levels of coverage both in types of coverage and monetary amounts. The typical mini-medical plan includes doctor’s office visits, wellness, outpatient diagnostic lab and X-Ray, emergency room for accident, hospital, surgical and usually a prescription drug benefit most often seen as a discount card. Sometimes mini-medical plans or Limited Medical Benefit Plans are offered with deductibles or co-payments. These plans may even include PPO Networks, vision coverage, and prescription drug coverage, a nurse line for the purpose of reducing visits to healthcare providers, lab programs and Flex 125 participation.

These types of limited plans are usually very basic in nature and operate off of the fixed dollar schedules or copay and deductibles. The Limited Medical Benefit Plans are easily understood members. Limited Medical Premiums often range from $20 to $190 for single coverage per month, depending on the level of benefits (family coverage ranges from $100 to $500). Limited Medical Benefit Plans may or may not require pre-existing condition limitations, be guaranteed issue, have no medical questionnaires and no participation minimum requirements. Many Limited Medical Benefit Plans also have a life insurance benefit.

Limited Medical Benefit Plans are a breakthrough in the health insurance industry for the cost conscious employer. They are an innovative new concept of offering Limited Medical Benefit Plans to blue collar, part-time and hourly employees, independent contractors and even companies canceling their major medical insurance in favor of additional savings. This target market and is the fastest growing component to the insurance industry. Limited Medical Benefit Plans can also be offered to individuals whether employed or not. Limited Medical Benefit Plans are a threshold, base health indemnity policy that has caps on all benefits and annual maximums on all benefits and which pays only Limited Medical Benefit Plans. These types of plans pay for nothing or offer Limited Medical Benefit Plans for catastrophic conditions and are not liable for catastrophic losses as a major medical plan. Limited Medical Benefit Plans are not designed to cover such conditions as HIV, cancer, pregnancy or any major condition. Limited Medical Benefit Plans are limited risk and liability plans. Limited Medical Benefit Plans are not major medical insurance, but are a supplemental health plan, usually filed as a hospital indemnity plan.

With the costs of healthcare skyrocketing and no end in sight, and with the economic recession and credit crisis occurring many companies are canceling their major medical plans and making the transition to the Limited Medical Benefit Plans. Many individuals can no longer afford their cost of their individual plans, and do not have the cost protection of lower costs because of working for an employer. There currently are only two choices for health insurance, major medical and limited medical. Catastrophic plans are just beginning to emerge, but have limited availability and coverage. Employers and employees, and individuals prefer Limited Medical Benefit Plans because they carry a first dollar benefit. Such plans are not concerned with the catastrophic but the immediate costs of health care.

HDS Insurance Service is an insurance agency specialized in providing the best Short Term Medical Plans, limited medical plans, critical illness plans, accidental insurance plans and benefits. The site is so committed and devoted in proving valuable service to provide long lasting relationship with clients.