Managed Care

Fee for Service

Choice

You choose a personal physician, selecting from among all the highly qualified and thoroughly credentialed physicians in the health plan´s network. And you´re free to change your personal physician at any time.

Some patients end up picking a doctor from the phone book - with no way to be sure that the doctor meets high professional standards or stays up to date.

Partnership

You and your physician work together to be sure you get the right care, at the right time, in the right setting. Your physician coordinates your care, making sure you get to see the right specialists, when necessary.

There´s more emphasis on treating illness than on maintaining health. Hit-or-miss coordination of care - or no coordination at all - means you can´t be sure that you´re getting the right care at the right time.

Quality

Health plans provide networks of professionals willing to be held accountable for the quality of their services and for patient satisfaction.

Quality varies widely. There´s no systematic way to ensure professional accountability or to avoid inappropriate treatment and unwarranted procedures.

Prevention

Because helping you stay healthy is just as important as treating you for illness, health plans strongly emphasize check-ups, health screenings, smoking cessation, fitness programs and other preventive steps.

Old-style insurance doesn´t reward doctors for keeping you well - they pay them for treating you when you get sick. So prevention and wellness don´t get as much attention as they deserve.

Information

Informed patients are empowered patients. Health plans encourage physicians to share information with patients on their health status, medical conditions and treatment options.

Often the only information you get is on bills. And care can be so complex that you may be in the dark about what is being done and why - let alone whether there are other options.

Affordability

Health plans provide comprehensive coverage, with very low out-of-pocket costs. You never have to worry about how you´re going to pay for care. And coordinated care helps keep care affordable.

Coverage is uneven. Out-of-pocket costs can be high - and unpredictable. When illness strikes, the last thing you need is financial crisis - but as costs pile up, care can become unaffordable.