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What the heck are managed health care plans

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At HealthCompare, we get asked questions about Health Plans everyday. We know the questions you are asking and know the answers. We have taken this knowledge and created some slide presentations. This one is on Managed Health Plans. Enjoy

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Page 2: What the heck are managed health care plans

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What are Managed Care Plans?Managed Care Plans consist of a network of doctors and hospitals, or “providers.” You must choose among the providers in their network.

You can only receive the benefits of the discounts negotiated with specific doctor, hospitals, and health care providers in their network.

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HMOs: Health Maintenance Organizations

PPOs: Preferred Provider Organizations

POS: Point of Service Plans

We’ll focus on the first two…

Page 4: What the heck are managed health care plans

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Page 5: What the heck are managed health care plans

HMO (Health Maintenance Organization) Insurance company determines care

provider May be limited with coverage area or

available doctors Limited number of specialists Typically limited care options

PPO (Preferred Provider Organization) You determine care provider Typically national coverage Options for any specialist Options for best available care

==

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HMO

P

O

P

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They often require you to see a provider within the network and to obtain referrals from a primary care physician.

These restrictions help to control costs.

Page 7: What the heck are managed health care plans

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If you decide that an HMO is the right plan for you, don’t forget to keep asking questions.

HealthCompare helps you to compare similar plans to find the perfect one for you.

Page 8: What the heck are managed health care plans

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Questions to compare plans: How do I determine which doctors are accepting

new patients? Can I change doctors? How are referrals handled if I need care from a

specialist? How is emergency care handled? What services are covered, including preventive

care? What if I need services not provided by the HMO

network? Are there additional fees or co-payments required

for office visits, emergency care or other services and, if so, how much are they?

Page 9: What the heck are managed health care plans

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Preferred Provider Organizations (PPO) are a form of managed care plan. PPO does not necessarily require

that you choose a primary care physician to supervise and make decisions for your health care.

In addition, with a PPO, you may be able to access providers and services outside of the “preferred” provider network.

Page 10: What the heck are managed health care plans

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It is important to note that PPO plans will likely involve more out of pocket costs than an HMO.  PPOs typically involve deductibles, co-payments,

and coinsurance amounts.  The increased financial responsibility with a PPO is

a trade-off for the higher level or flexibility that you have in choosing a provider and accessing care.

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What services are covered? What are the deductible, co-pay and coinsurance amounts?What is the out-of-pocket maximum. What are the coinsurance amounts for non-preferred or out of network providers? Are there per-visit fees or other types of co-pays for in-network services? What is the cost difference between using in-network and out-of-network doctors, and what costs are associated with care outside of the PPO?

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Who is HealthCompare: HealthCompare is your online one-stop-shop for health insurance

where you can research and compare plans online from over 150 national carriers.

We Promise: To give you the best results for YOU, we never promote one carrier

over the other. We just assess your needs and show you the best options from national carriers with plans in your area.

Our Commitment is to YOU: As a division of The Word & Brown Company who has been the

leading source for small group health insurance for over 20 years, we have leveraged technology to build an easy-to-use research tool, supported by a world class customer service team.

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OurPromise

#1

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1. You can enter your information

anonymously

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Page 14: What the heck are managed health care plans

2. You can review your plan options

online in seconds

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Page 15: What the heck are managed health care plans

3. You can even compare

plans side-by-side

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Page 16: What the heck are managed health care plans

4. Then, you can apply online or call one of our

trained Benefits Advisors for help!

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Page 17: What the heck are managed health care plans

Call toll free 877-641-1101

to speak to a trained Benefits Advisor

or…Go to HealthCompare.org today!

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