What Is a Medical Services Plan?

A medical services plan is a type of health care coverage that provides payment for medical services provided through a doctor or at a doctor's direction. Thus, if a patient goes to a doctor for a chest cold, the plan would cover the office visit, chest x-rays if the doctor orders them, and any necessary medications to treat the cold. Such plans can be administered in a number of different ways, including through the government, an employer, a community organization, or a private group.

Governments may offer a medical services plan to all or some residents, depending on the structure of their health care system. Residents must enroll in the plan and may need to see certain providers. The government determines which services it will pay for, and requires patients to pay out of pocket for other health care needs. Some medical services plans have a copay for office visits, prescriptions, and so forth, and the amount of this copay can vary. In nations where all citizens are not automatically eligible for assistance with health care, they may need to submit documentation like proof of income to demonstrate that they are eligible for the medical services plan.

Employers may offer a medical services plan; large companies as well as institutions like colleges and universities typically provide health care to their employers. In a school setting, students can also join the plan. The employer may pay for all or part of the plan. Members of the medical services plan usually need to visit approved care providers, sometimes at a health center maintained by the company, unless a doctor feels an outside referral is absolutely necessary. The medical services plan will cover anything from ambulance transportation to surgery.

Some community organizations have a medical services plan, usually to help meet the needs of low-income residents. Community clinics may provide health care for free or at low cost to people who meet income standards. Additionally, organizations may offer assistance with health care for children, cancer patients, and other specific patient populations.

Another type of medical services plan is a private arrangement where patients pay a flat yearly fee in exchange for medical services. The doctor sets the fee and provides basic care as well as lab tests and other services through her office. If the patient needs to see a specialist, the plan may or may not cover this, depending on the terms. Such plans can help patients save money on health care expenses, but the terms should be reviewed carefully.