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What is Managed Care?
In contrast, what is traditional health care?
How are managed care health plans typically selected and paid for? |
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Large
Employer Groups
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Small
Groups & Individuals
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Medicare
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| Plan Selection
Employer get quotes from various plans (Benefit consultants or coalitions may arrange quotes and negotiate selections ) Employer Selects Multiple Plans Employees select a plan from Employer list |
Plan Selection
Owner or Individual get quotes from various plans (Agent may arrange quotes) Owner or Individual selects a plan for themselves or their business |
Plan Selection
Government contracts with Plans Contracting Plans market to Medicare Consumers Interested Medicare consumers select from list of available Plans |
| Payments Employer pays each contracted plan premiums for covered employees Employer withholds contribution from employee paychecks Members pay copayments and other out-of-pocket expenses when they see providers |
Payments Individual/Employer pays plan premiums Small Groups withhold contribution from employee paychecks Members pay copayments and other out-of-pocket expenses when they see providers |
Payments Government pays each contracted plan premiums for covered person Medicare members pay plan any additional required premium Members pay copayments and other out-of-pocket expenses when they see providers |
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