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How can I learn all about a managed care plan before making a commitment?

Dr. Michael Roizen, MD
Internal Medicine

You can read the Summary Plan Description (SPD), a guidebook of the plan, to get a better idea of the coverage offered and the cost of the coverage for a managed care plan.

Before you go see the latest movie, you read the reviews. Before you go on vacation, you get brochures and guidebooks or go online to learn more about the destination.

The same is true about managed care (or any type of health insurance for that matter). If you’re getting insurance through your employer, your benefits office should be able to provide you with the 411 on each plan before you have to sign on the dotted line. If not (or even in addition), there are tons of resources online (and in brochures) from the Agency for Healthcare Research and Quality (AHRQ), the National Association of Insurance Commissioners (NAIC), the YOU Docs, and even the health insurance companies themselves. You can read the Summary Plan Description (SPD), a guidebook of the plan, to get a better idea of the coverage offered and the cost of the coverage. However, that can be harder to understand than a newly discovered language. So consult your friends at your State Health Insurance Assistance Program (SHIP). They can give you free guidance about all of your options so that you can find a plan that fits you as well as Cinderella’s glass slipper fits her.

 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.