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How Do I Choose the Best Managed Care Plan?

By Crystal Cook
Updated May 17, 2024
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Managed care is a common form of health insurance in which lower costs are exchanged for managed health care. A managed care plan can be extremely affordable when compared to fee-for-service, or indemnity, plans, but finding the right managed care plan for your needs can be challenging. You may want to start by considering which services you need and which you don't, and looking for plans that offer only what you need. Shopping around and investigating any companies from which you may be interested in purchasing a plan also can be helpful, as can knowing what providers they use and what services they cover.

There are several things to consider when trying to find the right managed care plan. The cheapest plans are often those offered by employers. Finding a good plan while you are healthy is recommended, because it will allow you to get the best possible plan for the best price. The plan's deductible is a major consideration, because a higher deductible will usually mean lower premium payments. It also means you will be paying more out of pocket for health care until your deductible is met.

It's generally a good idea to consider what type of coverage you want or need, and look for a plan that provides it, because getting rid of coverage you don't need can cut costs. For example, if you have dental insurance through another provider, you could ask the company to drop dental coverage on your managed care plan. This can help you tailor the plan to better suit your needs. At the same time, you should keep in mind that cutting coverage may leave you paying more for medical care if a sudden need arises for care you no longer receive under your insurance plan.

Investigating any managed care plan company in which you are interested also can be beneficial in making your choice. Start by calling the company with your questions; if you are on hold for a long period of time or do not get a satisfactory answer, then it may not be the company for you. You also should find out about the doctors who are listed in your plan. The American Medical Association provides free resources that allow people to find out about malpractice complaints against doctors. You also can ask friends and family for their opinions on what companies are good ones.

It also is important for you to decide what is important in a managed care plan. If you want to use the same doctor you have used for the past 10 years, then you should make sure that doctor is a provider for your plan. You also should know what pharmacies, hospitals and other providers are available through a plan. Another thing to consider is what the plan defines as an emergency because, if the insurance company's definition is different from yours, then you might have to pay for some emergency care.

WiseGeek is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.

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