Managed care health insurance plans account for most health insurance plans in the United States. In managed care plans, a health insurance company provides a network of health service providers that individuals can access for care at a reduced cost. There are several different types of managed care insurance. Although managed health care was developed to curb the rising costs of medical expenses, costs have continued to soar. Because managed health insurance plans are the primary plans used in the United States, individuals should know three things about the plans before they obtain them: the plan's network can affect what doctors people can choose, the type of plan an individual has can affect how he or she must pay, and not all services are covered under managed care health insurance plans.

First, managed health insurance plans typically include a network of health care providers. Although there are different types of managed care health insurance plans that operate slightly differently, most plans have a network or preferred providers that patients can use. Using a provider outside this network may mean that the individual must pay more for medical services because he or she will not be reimbursed by the insurance company. For this reason, the network will usually determine, in part, what doctors an individual can see without paying additional costs, and because of the rising costs of healthcare, most patients will not want to see a health care provider who is not covered by the network.

Second, managed health insurance plans come in different types. The Health Maintenance Organization (HMO) is the most popular. With this health insurance plan, individuals can only go to doctors within the organization's network. Outside of the network, the HMO will not pay for care. A Preferred Provider Organization (PPO) is a type of health insurance that allows individuals to seek care outside of the network. However, the PPO will generally contribute larger payments when the individual uses an in-network provider. Finally, a Point Of Service (POS) plan requires individuals to choose a primary doctor within a network but will offer compensation outside of the network if that doctor makes referrals elsewhere.

Third and finally, consumers need to know that not all services are covered under health insurance plans. Even if a doctor is covered, this does not mean that the service itself will be covered. In some cases, health insurance companies will deem a procedure unnecessary, meaning individuals will have to pay for it on their own.

Managed care health insurance plans are common in the United States, and customers who are going to use them need to understand these issues so they can use the plans effectively.