What is one aspect in which managed care differs from conventional insurance? Well, it is the assumption of risks that would be taken in having to purchase an insurance plan. I know that some of you might be wondering what type of insurance to get for yourself, your family, or your loved ones. Although in today’s time, having insurance is better than having none at all.
One of the main benefits of having insurance is that in case of unavoidable accidents like what commonly happens every day, you will have a backup on the spot and an urgent source of financial assistance.
We don’t want to go out of money when we really need it, right? So I advise you get insurance in which you understand how it works and how well you could benefit from it, especially if it is medical insurance we’re talking about.
Difference Between Managed Care and Conventional Insurance
If you compare managed care insurances with conventional ones, there is much to learn. What is one aspect in which managed care differs from conventional insurance? There is a significant aspect that is most noticeable among all of them, and that is the assumption of risks.
But before we jump into that, let’s get to know more about Managed Care and Conventional Insurance.
Managed Care Insurance
A Managed Care Insurance is a good choice for insurance if you want to pay less for your health care bills. However, you could not choose the health care providers of your own choice. It means you will not be able to choose which doctors and which hospital you’ll get treated at. The Managed Care insurance will, in turn, take care of almost all of your medical care needs.
There are 3 types of managed care plans namely, the Point of Service (POS), Health Maintenance Organizations (HMO), and Preferred Provider Organizations (PPO).
Let’s get to know each one of them.
POS is called in various names because it has diverse, varying features. Some aspects of traditional medical insurance, HMOs, and PPOs are combined in one insurance. So, what does this mean?
Let’s take each type’s attributes one-by-one. The POS Plan members could choose the point of service of choosing the doctor or hospital with or within the contract of the insurer.
Although when it comes to paying and coverage, you might want to reconsider having this. The POS plan covers less compared to other insurances when it comes to members taking service from companies outside their network. The plan also requires a higher coinsurance cost for medical assistance received outside.
If you are insured as an HMO member, you will have to pay a monthly amount like paying for premium insurance, where in exchange will give you access to a wide range of health services.
On the other hand, PPOs are like giving you a discount with their contracted health care provider companies. To put it simply, the insurer contracts some health care providers to control the cost of their services, giving the customers and their member’s benefits and discounts out of it.
These PPO members will be charged lower than the usual price of service compared to the non-members. Some consumers choose the PPOs mostly because they could choose their preferred health services that pay less insurance than the non-preferred ones.
A Conventional Insurance or most commonly known as Traditional Health Care Insurance, differs from the fore mentioned Managed Care Insurance by choosing your options. Traditional Care Insurance is great because it lets you choose the health care providers of your preference. That means you could choose which doctor or hospital you will be serviced to.
Although when it comes to paying, you may have to pay the bills by yourself at first, then you could get reimbursed by the insurance company afterward. On that note, the insurance company will only reimburse what was agreed upon in your policy agreement.
In some circumstances, it is better to purchase an insurance policy through a marketplace in some states established by the Affordable Care Act. You may also be required to pay a coinsurance fee on medical expenses like tests or stay in a hospital.
If you happen to have a medical condition that requires more visits to the doctor, increase your insurance coverage, or are prone to accidents, it is better to research plans that have more coverage.
There are basically three types of health insurance plans, employer-sponsored, self-employed, and a COBRA plan. The difference between the three is whether you pay your insurance yourself or your employer does.
So if you are wondering what is one aspect in which managed care differs from conventional insurance, the risks are taken are. Although having known each type of health care insurances, I hope you can choose which one is relevant for your needs.
It is important to know which one you could use, affordable, and most benefit from so that you could make the most out of what you pay. It is only normal to seek these benefits. I mean, who wouldn’t?