Sunday, 15 February 2009

Health Care Insurance - Managed Care Health Plans

By Jordan FeRoss

A managed care health plan works as a network. It is a group of medical personnel and facilities that have a contract with this particular plan. They all work together to offer medical services to those that are members. For the most part, this plan has requirements that members use the medical personnel and facilities within the plan's network. In a nutshell, using this plan is limited as far as providers, but benefits you on the cost. Health care insurance in Texas uses this overall plan.

A managed health care plan is usually cheaper than fee-for service plan. For health care insurance in Texas, their reasoning for charging lower rates is because their hand picked medical personnel and facilities. They allow low rates for these kinds of plans. This plan also focuses on taking care of yourself so that you can avoid getting sick unnecessarily.

The managed care health system uses three types of plans:

HMO (Health Maintenance Organization) - An HMO requires you to use the doctors and hospitals in their network. This is fairly standard with most health insurance in Texas. An HMO requires members to choose a primary care physician from their network of providers. The PCP must approve all procedures and visits to specialists. Patients pay a deductable for every office visit.

PPO (Preferred Provider Organization) - This plan allows you to see any doctor you choose. The only disadvantage with this is that if the doctor is outside of the network, you will have to pay more. With health care insurance in Texas, it is strongly encouraged that people use a doctor within the network.

POS (Point Of Service) - POS plans are great for anyone who's been with a doctor and does not want to change when there is a change in insurance as they tend to have sizable networks. And, like the PPO, patients can see any doctor they'd like without a referral but there is still a network of doctors. Patients choosing to leave the network will find their medical bills much higher than with other health insurance in Texas. A POS plan also the most expensive type of plan because there are fewer barriers for the patient before he/she can receive care.

Most health insurance options in Texas will require you to pay some type of premium, even with employer sponsored plans. Sometimes you will have to pay your entire deductible before the insurance will cover a single dime even for surgery or emergency room visits. Your deductible the amount you have to pay before your benefits kick in. This is one of the factors you want to consider when choosing a health care plan.

Co-pays are another cost consideration for anyone choosing a health insurance plan in Texas. You usually need to cover your co-pays for every doctor and hospital visit and when filling prescriptions, even once you meet your deductible. With several managed care insurance plans (especially an HMO), there are limits to a patient's out-of-pocket annual expenses so costs do not get out of control.

Since there are so many variables involved with health insurance plans, it is important to consider your choices wisely before making a decision that can have a dramatic effect on your physical and financial health over the years.

About the Author:
If you are one of those seeking Texas health insurance then you can find some of the best deals on health insurance in Texas. Texas Health has great rates and resources to choose from!


Ricky said...

Many thanks for sharing this informative post. One has do a careful research and analysis regarding which managed care plan to prefer. The plan should suit your needs. The coverage provisions and additional costs fluctuate considerably from plan to plan, so do invest time and put effort and make clear your doubts as soon as possible.

Florida Health Insurance Plan

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