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September 17, 2012

The Law and Your Health

Basics of Managed Care

What are some of the concerns with managed care?

The biggest criticism of managed care is that your doctor is no longer given the final say on what type of treatment is covered. Now the managed care organization gets to make—or at least influence—that decision. The problem is that the doctor’s opinion on what is needed may differ from the health plan’s opinion of what it should cover. Bear in mind that the person at the health plan who is influencing your care may not be a doctor or nurse. That person may not have any medical training whatsoever.

>>How is managed care defined?
>>What are some of the concerns with managed care?
>>How does this affect me?
>>What are the states doing to ensure that patients get the care they need within the managed care system?
>>What are some specific legal protections for consumers?

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