Managed Health Care: The Right Fit?

Managed health care offers affordable insurance with restrictions. Find out if it's a good fit for you.

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Managed health care: the basics

Managed care health insurance provides health care for a low price.

Managed care health insurance controls the access to health care. Your choice of doctors and facilities is limited to a network approved by your insurance company.

Managed care health insurance plans cover preventative care and most medical services. However, to be covered for certain medical services, following policy procedures is critical.

Managed health care: the price

Costs for preventative care are always covered. Other medical services are fully or partially covered but you must follow policy procedures and only obtain medical services from physicians within the network.

Here's what you pay:

  • monthly premium.

For network care you pay:

  • a co-payment for certain medical services,
  • a low per visit coinsurance.

For non network care, you pay:

  • an annual deductible,
  • a high coinsurance,
  • any amount the insurance company deems unreasonable for the medical service.

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Managed care health plans: the types

Managed care health plans come in three forms:

  • PPO, or Preferred Provider Organization,
  • POS, or Point-of-Service,
  • HMO, or Health Maintenance Organization .

The three types of managed care health plans differ in compensation for treatment outside the network.

We'll discuss these more thoroughly.

Next: Health Maintenance Organizations

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