What Is a Physician Health Plan?

Health insurance is a valuable form of financial security for people who have it, safeguarding them against the high costs of medical care and providing affordable access to a range of services. But shopping for a health plan is not an easy task. Physician health plans are just one of the options available to health insurance customers, offering access to care within a designated network of physicians.

Definition

• A physician health plan is a form of health insurance offered by a physician-sponsored network. These networks are nonprofit health maintenance organizations that bring together a number of physicians in private practice who collectively own and administer the network, along with the individual health plans it offers to customers. Physician health plans allow their customers to visit doctors, hospitals, clinics and dentists throughout the network, all for the same rates.

Features

• Physician health plans are typically regional, consisting of doctors and health care facilities in a specific local area. This, however, does not mean that all physician health plan networks are small. Some networks that offer physician health plans, such as the Physicians Health Plan of Northern Indiana, include more than 2,000 health care providers. Physician health plans include coverage for both treatment of existing illness and preventive treatment to improve overall health before illness occurs.

Benefits

• One of the key benefits of a physician health plan is the fact that it operates independently of any major health care provider. Physician health plans promote themselves by calling attention to their nonprofit status and ability to deliver personalized care within a local area, thereby distancing themselves from corporate health care providers that some customers may see as impersonal. Physician health plans also allow the physicians who participate to build their practices by drawing new patients from the plan and networking with the other participating health care providers.

Participants

• Physician health plans are open to a mix of individual and business customers. Individuals can buy into the plan to provide coverage for themselves and their families. Some physician health plans offer high deductibles to keep monthly premiums low for individual customers. Businesses can also buy into physician health plans as a way to provide group health insurance to their employees. Employers pay lower rates than individuals because they allow the physician health plan to distribute the risk of claims among all members of the workforce, some of whom are less likely to need expensive care than others.