Healthcare is expensive, and you don’t have to have gone through the system to realize that. Going to the doctor costs some serious money, which makes finding ways to make the cost go down a serious priority. Manage care is designed to reduce the unnecessary costs of healthcare while still improving the quality of that care.
The plans have arrangements with certain doctors and hospitals. If you are a plan member and go to one of those doctors or hospitals, then you get a reduced rate, less paperwork, and spend less money. You can select a primary care doctor from the list of those under the plan, and they will become the person who takes care of your general medical needs such as annual checkups, exams, and other common medicinal practices. A managed care consultants service will often help you figure out the technical details.
If you require specialized medical care, then your primary care physician will need to refer you to a specialist in order for you to get the continued coverage. If you seek out a specialist yourself, then you won’t get the coverage. The managed care plans can be great if your doctor or treatment is on the list and covered, but it can also be a problem if the things you need aren’t eligible for coverage.
Those restrictions of who and what are in the network are the reason why the plan is so inexpensive. Some plans give the same amount of coverage if you see someone outside of the network, but will require you to pay a higher co-pay when working with them.
Be sure to look through the Summary Plan Description that’s given to you with the plan, and do some research on the pros, cons, and available doctors and treatments in the plan, that way there are no surprises and you can get the care you need.