Learn about the various types of healthcare coverage options* available to you in the United States and around the world through participating Blue Cross and Blue Shield companies.
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Common Insurance Types
Flexible Spending Accounts (FSA)
A FSA is an account that reimburses employees for specified expenses (for example, health care or dependent care) as expenses are incurred. FSAs are usually funded through deductions from employees’ paychecks. If the FSA meets rules under the Internal Revenue Code, contributions are not subject to federal income taxes or employment taxes.
Health Maintenance Organization (HMO)
An HMO is a type of health benefits plan for which members are required to receive health care only from providers that are part of the HMO network. A primary care physician coordinates each member’s health care. Services (except emergency care) performed by out-of-network providers aren’t covered except under specific circumstances.
Health Savings Account (HSA)
An HSA is an account that reimburses employees for specific health care expenses. HSAs can be funded by the BCBS company member, an employer or anyone else. The money contributed to your HSA belongs to you and can be used to cover eligible current or future medical expenses. If the HSA meets rules under the Internal Revenue Code, contributions, earnings and withdrawals for eligible expenses are not subject to federal income taxes or employment taxes. For more information about qualifying expenses and the HSA regulation, Section 213(d) of the IRS Tax Code, visit the IRS website.
Medicare is federally funded health insurance, typically for those aged 65 and over, or for people under 65 who are disabled or meet other special criteria.
There are several parts that make up Medicare and each is designed to cover some of your healthcare needs. These are:
- Medicare Part A: Covers some of your inpatient hospital stays, rehabilitation and some additional skilled nursing care.
- Medicare Part B: Helps to cover your doctor visits and other medical services like x-rays and lab tests.
- Medigap: This works with A and B and fills in specific cost sharing gaps where A and B might not cover all the services you receive, like helping with some of your copays or coinsurance costs.
- Medicare Advantage (Medicare Part C): Covers all Medicare Part A and B benefits and may offer lower cost sharing and additional benefits that Medicare doesn't cover.
- Medicare Prescription Drug Plan (Medicare Part D): Helps you with your prescription drugs costs.
To learn more about Medicare and which BCBS Medicare Coverage options might work for you, try our free AskBlue Medicare Guide.
If you have more questions about Medicare, visit. www.medicare.gov to find detailed information from the U.S. government on any of the Medicare products and regulations.
Preferred Provider Organization (PPO)
A PPO is a Plan that allows members to choose any provider but offers higher levels of coverage if members receive services from health care providers in the plan’s PPO network. These in-network providers are contracted with the health plan to provide services at negotiated reimbursement rates. Members enrolled in PPO coverage can also receive coverage for services by healthcare providers who are not part of the PPO network.
Health Reimbursement Arrangements (HRA)
An HRA is an account that reimburses employees for specific health care expenses as expenses are incurred. HRAs are funded by employers.
Indemnity (also referred to as Traditional Insurance or Fee-for-Service)
Indemnity, also known as traditional insurance or Fee-for-Service, is a traditional insurance plan that reimburses for health care services provided to members based on providers bills submitted after the services are rendered. It allows for members to select any healthcare provider but its benefits are maximized when using a participating Blue Cross and Blue Shield company.
Point of Service (POS)
Point-of-Service coverage is a healthcare option that allows members to choose medical services as needed and whether they will go to a provider within the Blue Cross and Blue Shield network or seek medical care outside of the network.
Medicaid is a joint federal and state program that provides hospital expenses and medical expense coverage to the low-income population and certain aged and disabled individuals.
*These definitions are not meant in every case to confirm to the definitions in a member’s health plan contract or evidence of coverage. If you are a member, please look at your health plan documents for the definitions that govern your health plan benefits.