Transcription of TABLE OF CONTENTS - Patient Advocate
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TABLE OF CONTENTS - Patient Advocate
TABLE OF CONTENTSINTRODUCTION..2 PART I: UNDERSTANDING MANAGED care TERMINOLOGY..2 Description of Managed care ..2 Managed care Organizations ..3 Common Definitions for Types of Managed care ..4 Managed care Payment Methods ..5 Specific Features of health Maintenance Organizations ..6 HMO Organizational Models..7 Glossary of Managed care Definitions ..7 PART II: A CONSUMER GUIDE TO SELECTING AN INSURANCE PLAN..15 Navigating Your Plan ..16 Evaluating Managed care Plans ..17A. Benefits Offered or Covered Services ..17B. Cost vs. Benefits ..19C. Services of the Primary care Physician ..19D. Prescription Drug Benefits ..21E. Provider Network and Geographic Service Area ..21F. Commitment to Quality of care and Service ..22G. Customer Satisfaction ..22H. Limitations or Maximums ..23I. COBRA ..23 Summary and Conclusions.
INTRODUCTION The Managed Care Answer Guideis designed to help people make decisions about choosing a health care plan. This guide is also designed to assist consumers in understanding parts of their health care plan that may be confusing once they have made health insurance choices.
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