From: Gene McAloon 

On Tue, 24 Feb 2004 16:48:56 -0500, "John Beamish"
 wrote:

>What's the difference between an HMO and a managed care option?

There are variations, but essentially HMOs are groups of which you have to
be a member to use their services. Those services are provided only by
those designated by the HMO. You can use only those providers.

Managed care outfits are usually insurance companies. Anyone who can afford
their premiums can use them. The plans vary all over the place, some being
much more restrictive than others. For example, with the basic plan, you
can use only
providers designated by them (as with HMOs). Pay a higher premium or a
higher co-payment and you can choose your own providers.  It is the greater
flexibility
of the insurance companies' managed care plans that makes them so
attractive to employers.

With either HMOs or managed care plans, you can end up arguing with some
clerk about whether your medical care will be paid for and how much of it
will be paid
for. The real problem there is that they often use average prices for particular
types of care. If your provider charges more, for example if there were
complications, the plan may refuse to pay or pay only the average price for
that
service and you are stuck for the difference.

It is a rotten system, if you can call it a system at all.

>
>"Gene McAloon"  wrote in message
>news:a0fn301hjanv5rdv4ahpjkuogj3bl2v7h5{at}4ax.com...
>>
>> That's contrary to my observations. When an employer offers both managed
>care
>> and HMO programs, the employees overwhelmingly opt for one of the managed
>care
>> options, not HMOs.
>>
>

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