Managed care plans are those where the insurance company makes treatment decisions for the patients. They include HMO's, PPO's, and Kaiser plans. The insurance companies limit your care in order to save them money. These plans are usually much less expensive than indemnity insurance.
Health insurance and health care combined. These plans are what people usually refer to as health maintenance organizations (or HMOs) but they include HMOs and competitive medical plans (CMPs).
Health care plans in which subscribers contract directly with the provider organization, which furnishes comprehensive health care services for a fixed fee from a designated group of providers who meet stringent selection criteria. These plans emphasize cost control and preventative treatment.
An insurance plan that requires patients to see doctors and hospitals that have a contract with the managed care company, except in the case of medical emergencies or urgently needed care if you are out of the plan's service area.
These plans typically offer a full selection of health-care benefits, including routine physicals and vision examinations, at the most affordable premiums. Managed care plans have a smaller selection of physicians. In addition, a primary care provider (PCP) is required to coordinate all your health-care needs.
Health care plans where beneficiaries will be generally only be covered when they go to doctors and hospitals in the plan's network, except for emergencies. Two common types of managed care plans are HMOs (Health Maintenance Organizations) and PPOs (Preferred Provider Organizations). Costs are often lower for managed care plans than for Original Medicare plans.
Health plans in which the individual must first consult a primary-care physician selected in advance from a list of approved physicians.
Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care, programs for reviewing the medical necessity of specific services, increased beneficiary cost sharing, controls on inpatient admissions and lengths of stay, the establishment of cost-sharing incentives for outpatient surgery, selective contracting with health care providers, and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as health maintenance organizations (HMO), independent practice associations (IPA), and preferred provider organizations (PPO), etc.