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Managed Care

Managed care plans attempt to provide members with health care services at the lowest cost possible. Most managed care plans also focus on prevention and healthy living in order to avoid health care costs altogether. Managed care usually provides both the financing and delivery of health care services.

Currently, many health insurance plans available to consumers are managed care insurance plans. By specifying a network of health care providers, managed care plans permit insurers to influence the treatment options of their clients. Included in this category are Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), and Point of Service (POS) plans.

The Drawbacks of Managed Care

Consumers often purchase managed care plans because they are relatively inexpensive, but be aware that the choice of health care providers is nearly always restricted in a managed care program. You should be sure to check the list of health care providers in your area as some health insurance carriers will have more providers to choose from in your area than others.

Consumers should also be aware that managed care plans generally provide less flexibility in obtaining healthcare than other types of coverage, like indemnity plans. In addition to the limited choices of providers, managed care policyholders must often seek the approval of the health insurance company before obtaining treatment. Individuals covered by an HMO plan must get prior approval from their primary care doctor before getting any type of specialized treatment.


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