Managed Care
Educational information. Individual clinical review of this presentation by Dr. Ehsan is not yet documented. It does not replace personal medical evaluation.
Source: MedlinePlus, National Library of Medicine. Read the original source
MedlinePlus data edition September 26, 2026. Imported September 27, 2026. These dates do not indicate a new clinical review of the article.
Managed care plans are a type of health insurance. They have contracts with health care providers and medical facilities to provide care for members at reduced costs. These providers make up the plan's network. How much of your care the plan will pay for depends on the network's rules.
Plans that restrict your choices usually cost you less. If you want a flexible plan, it will probably cost more. There are three types of managed care plans:
- Health Maintenance Organizations (HMO) usually only pay for care within the network. You choose a primary care doctor who coordinates most of your care.
- Preferred Provider Organizations (PPO) usually pay more if you get care within the network. They still pay part of the cost if you go outside the network.
- Point of Service (POS) plans let you choose between an HMO or a PPO each time you need care.
Questions for your care team
General prompts to help prepare for your appointment.
- How does this information apply to my situation?
- Which symptoms or results need evaluation?
- Which tests are useful, and what can they tell us?
- What care options, benefits, and risks should we discuss?
- When should I seek urgent help, and whom should I call?
- When is follow-up, and how will we know whether the plan is working?
For a life-threatening emergency, call 911 in the U.S. or your local emergency number.
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