A service of the U.S. National Library of Medicine 
National Institutes of Health
Managed Care
Managed care plans are health insurance plans that contract with health care providers and medical facilities to provide care for members at reduced costs. These providers make up the plan's network. How much of your care the plan will pay for depends on the network's rules.
Restrictive plans generally cost you less. More flexible plans cost more. There are three types of managed care plans:
- Health Maintenance Organizations (HMO) usually only pay for care within the network. You choose a primary care doctor who coordinates most of your care.
- Preferred Provider Organizations (PPO) usually pay more if you get care within the network, but they still pay a portion if you go outside
- Point of Service (POS) plans let you choose between an HMO or a PPO each time you need care
The top row in the table of contents box contains the following groups:
Basics
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Learn More
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Multimedia & Cool Tools
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For group Basics
For group Learn More
For group Multimedia & Cool Tools
- No links available
The bottom row in the table of contents box contains the following groups:
Research
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Reference Shelf
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For You
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For group Research
For group Reference Shelf
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Overviews
- Health Insurance: Understanding Your Health Plan's Rules(American Academy of Family Physicians)
- Also available in Spanish
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Related Issues
- Managed Care (and Emergency Services)(American College of Emergency Physicians)
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Research
- Managed Care: Research Findings(Agency for Healthcare Research and Quality)
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Journal Articles
References and abstracts from MEDLINE/PubMed (National Library of Medicine)
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Organizations
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Children
- Managed Care Plans: Getting Good Care for Your Child(American Academy of Pediatrics)
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Seniors
- Medicare Advantage Plans(Centers for Medicare & Medicaid Services)
- Return to top
