To deal with the many issues that have come to be a part of the provision of health services including the many financial issues that have recently become a part of healthcare insurance policies, managed health care has been developed. For the many people living in all parts of the United States, this form of health insurance coverage has become the most common. It is through managed health care that plan members are able to receive the highest quality of healthcare along with many added benefits.

With managed health care the patient is assured of receiving the best possible healthcare in the right location, even if that location has to be their home because they are too sick to receive it anywhere else, and in need of regular ongoing care. There is also the assurance that the right provider will be used to provide the needed services. Different from other health insurance plans, these consist of only a few choice doctors and other healthcare individuals.

There are basically just three different varieties of managed healthcare plans that are available, and these are the HMO plans or Health Maintenance Organizations plans, the PPO plans or Preferred Provider Organizations plans, and the POS plans or Point-of-Service plans. Each plan has its own unique benefits and features that differ one from the other. Each plan also has its own restrictions and levels of choice. You need to compare these three plans and to determine which best meets your needs before deciding which one to select.

The HMOs set up individual contracts with particular hospitals and medical professionals that allow them to provide reduced rates to their members. Members are required to make a monthly payment and this is not dependent on whether or not they have seen a physician that month. To begin coverage they need to select a Primary Care Physician (PCP) who is a part of the plan, and they most always visit that physician prior to receiving services from other providers of care within the HMO’s network of care providers. In this manner, the PCP functions as a gatekeeper to the plans benefits. Therefore you need to be acquainted with the term PCP when reading materials provided by an HMO plan. What this means For example, is that if a patient has a heart problem they cannot see a cardiologist until they have first seen their PCP, who will then authorize the visit if he or she deems it necessary. Unless the member has been officially referred, he or she is not covered for any incurred charges claimed by the specialist. When you are a part of an HMO you can only choose to see those doctors that have been authorized through them. In the case that you may want to see your own family doctor for example, and he or she is not a part of the HMO plan, you will need to use another form of health insurance coverage or a plan in which your family doctor is included.

The PPO plan is very similar to an HMO plan, with the exception that the member does not have to work through a PCP. Just as with the HMO approach, the PPO plan offers a network of providers. The difference however, is that members are allowed to use their own doctors that may not be in the plan. If members do use plan doctors however, they will receive greater financial benefits. Since you are now being offered greater flexibility in the physicians that are now available to you, and because you need not now use a PCP before receiving care from a specialist, you will find that the PPO approach is more expensive than that of the HMO.

When referring to a POS plan, you are looking at what is essentially a mixture of the HMO approach along with that of the PPO. In this case, members may choose to be a part of either a PPO type or HMO type of a plan depending on which of the two is most suitable to their needs. Some patients may need the flexibility that is offered by a plan where you do not need to see your PCP before signing a specialist because of an urgency for care. If this is the case, the individual is allowed to choose the PPO type plan and be charged a little bit more for his/her coverage. If urgency of care is not expected to be a need then for the needs of a member who only needs to see his/her physician to receive a required prescription, then the HMO plan will suffice. In this plan the patients may also decide on who they want to be their primary care physician. Because of the freedom of choice and lack of restrictions that are being presented to potential members, such plans are becoming increasingly popular.

Always consider each plan carefully and their individual benefits and restrictions before deciding on which plan you want to use. Make sure that the plan that you select is best fitted to your individual health needs.