What is an Indemnity Plan (Fee-for-Service)?

• A. Most comprehensive managed care with capitation
• B. Least managed care; providers paid per service rendered
• C. Requires PCP referral to see specialists
• D. Distributes care through a gatekeeper

Answer: (B)

Indemnity plans operate on a traditional fee-for-service model where patients have broad freedom to choose any licensed provider, and the insurer reimburses for services rendered rather than paying a fixed capitation amount. Because payments are made per service and there’s little or no network gatekeeping or referral requirements, these plans are the least managed type of coverage. Patients typically pay deductibles and coinsurance, and the insurer covers a portion of the allowed charges for each service. This describes paying providers per service rendered with minimal setup of care management, which is why that description fits best. The other descriptions reflect capitation, PCP referrals, or gatekeeping—features not characteristic of indemnity/fee-for-service plans.