Commercial Health Insurance

Updated: 09 June 2023

What Does Commercial Health Insurance Mean?

Commercial health insurance is any type of health insurance policy not offered or provided by the government. Providers are for-profit and offer both group and individual plans. Often, people enroll through an employer who either covers the entire premium or a portion of it, with the remaining cost deducted from the participating employee’s payroll.

Insuranceopedia Explains Commercial Health Insurance

Commercial health insurance generally is structured in one of three ways. A point of service plan, which is the most popular, lets policyholders choose a primary care physician (PCP) from a list the insurer provides. If a policyholder sees a doctor outside this network, they typically receive lower benefits for covered services. Another model is the health maintenance organization (HMO) plan. Similarly, it allows policyholders to choose PCP from an insurer established network of healthcare professionals. However, it generally does not pay for covered services received outside the network. Finally, the indemnity or fee for service model offers coverage for certain health care services and allows policyholders to see any health care professional they wish. Typically, coverage is limited though.

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