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Overview |
What is Managed Care?
In contrast, what is traditional health care?
How are managed care health plans typically selected and paid for?
| Large Employer Groups | Small Groups & Individuals | Medicare |
| 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 |
What is Defined Care?
How can I find out more about Defined Care?
Visit MCOL's Defined Care web site at www.definedcare.com, designed to keep you up-to-date on what's happening with Defined Care. Register for e-newsletters, review Defined Care-related articles, download Defined Care charts, articles and survey results that you can use for your presentations and articles.
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