When Should You Buy A Managed Health Care
Insurance Plan?
Health insurance plans today fall into two broad camps –
traditional indemnity health insurance (which tends to be
expensive) and managed health care insurance (which tends to be
more affordable). The best known form of managed care is that
provided by the Health Maintenance Organizations (HMOs) which
are designed to provide a moderate level of medical care at a
relatively low price.
For most people the thought of being able to obtain medical
care for a relatively low price sounds attractive but,
unfortunately, this can be very much a case of you 'get what
you pay for' and, unless you go into managed care with your
eyes wide open, you could be disappointed with the quality of
the care you receive.
Managed care works by strictly controlling costs and this,
in turn, means controlling access to care. A health maintenance
organization is essentially a network of healthcare facilities
(doctors, hospitals etc.) whose services are contracted for an
agreed fee.
Although the term managed health care should mean that
health care is managed, in reality it is often said to be more
a case of policyholders being managed, as they are largely
required to seek their healthcare within the HMO's network and
normally access to such healthcare is controlled by one doctor
to whom the patient is assigned. This often means that patient
choice is severely limited and that a policyholder may have to
join a waiting list for treatment.
In certain very limited circumstances policyholders will
sometimes be permitted to seek treatment outside of the network
but, where this occurs, the HMO will often require the
policyholder to pay any costs that are considered to be above
those which the HMO considers reasonable and customary for the
treatment in question.
Against this background, why would anybody choose managed
health care in preference to indemnity health insurance other
than for reasons of simple cost?
The major difference between indemnity insurance and the
managed care model lies in the cover provided. Indemnity
insurance is designed to cover the policyholder against
unexpected, and often very high, medical bill arising out of
serious accident and illness. Managed care on the other hand
focuses its attention on providing preventative care and aims
to keep policyholders healthy by assisting with the costs of
routine medical care including such things as vaccinations and
check-ups.
There are clearly many situations in which one form of
insurance would be more suitable than another but, for example,
if you are married with a young and growing family then you
might well feel that a focus on preventative medicine,
particularly for your children, would make managed care a good
choice.
For more information about a affordable health insurance plan or
low cost individual health insurance
then the best up-to-date information will be found right
here online.
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