Healthy Aging Health Center

Select a topic to explore more.
Select An Article
Font Size
A
A
A

Choosing and Using a Health Plan

Contents

 

  • Your Health Plan Affects Many Things
  • What Are Your Choices?
  • How to Make Decisions Based on Quality
  • Rate Your Health Plan Choices
  • Sources of Additional Information

Today there are more health plans to choose from than ever before. Not everyone has a choice. But if you do, this section can help you choose the plan that offers the best quality for you and your family.

The quality of health plans varies widely. In 1997, a study published by the National Committee for Quality Assurance (NCQA) showed differences in the ways managed care organizations provide access to care, keep people healthy, treat illness, deliver high-quality service, and satisfy patients. For example, studies show that treating heart attack patients with beta blocker drugs saves lives. The NCQA found that in some health plans, most heart attack patients got beta blockers. In other health plans, only one in three did.

Research shows that Americans say that quality is the most important thing they think about when choosing a health plan. But research also shows that few people understand their options well enough to make an informed choice.

Quick Check for Quality

Look for a plan that:

  • Has been rated highly by its members on the things that are important to you.
  • Does a good job of helping people stay well and get better.
  • Is accredited, if that is important to you.
  • Has the doctors and hospitals you want or need.
  • Provides the benefits you need.
  • Provides services where and when you need them.
  • Meets your budget.

Your Health Plan Affects Many Things

 

  • Who will care for you (doctors and other health care providers), and how much choice you will have.
  • What kind of care you will receive (for example, which preventive services are covered?).
  • Where you will receive your care (which hospitals, for example).
  • When you will receive your care (will you receive it when you need it?).
  • How you will be cared for (the quality of care you receive).
  • How much you will pay.

What Are Your Choices?

The two major types of health plans are "fee-for-service" and "managed care." Managed care plans can go by many names:

  • Health Maintenance Organization (HMO).
  • Preferred Provider Organization (PPO).
  • Individual Practice Association (IPA).
  • Point of Service (POS) plan, to name a few.

But different groups do not always define these names the same way.

Do not be confused by whether the plan is a "fee-for-service" plan, or whether the plan is one of the many kinds of managed care plans. What you need to understand is not the plan's label, but the characteristics of the plan. Research shows that it is important to understand your options and how they affect your choice of providers and services, costs, and quality of care.

1 | 2 | 3 | 4 | 5 | 6

WebMD Public Information from the U.S. Department of Health and Human Services

Next Article:
webMD Video

Show or hide information about video: Do You Need an Annual Check Up?   Do You Need an Annual Check Up?

Are annual checkups worth your time and money? Not everyone agrees.

Watch Video: Do You Need an Annual Check Up? (opens in a new window)

Show or hide information about video: Voice and Your Age   Voice and Your Age

Show or hide information about video: Improved Knee Implants   Improved Knee Implants

Show or hide information about video: Sharing Senior Secrets   Sharing Senior Secrets

Show or hide information about video: Do Your Hands Reveal Your Age?   Do Your Hands Reveal Your Age?

Advertise on Fox News Channel, FOXNews.com and FOX News Radio Jobs at FOX News Channel. Internships at FOX News Channel (now accepting Fall interns).
Terms of use. Privacy Statement. For FOXNews.com comments write to foxnewsonline@foxnews.com; For FOX News Channel comments write to comments@foxnews.com
© Associated Press. All rights reserved.
SMARTMONEY ® © 2006 SmartMoney. SmartMoney is a joint publishing venture of Dow Jones & Company, Inc. and Hearst SM Partnership. All Rights Reserved.
All quotes delayed by 20 minutes. Delayed quotes provided by ComStock.
Historical prices and fundamental data provided by Hemscott, Inc.
Mutual fund data provided by Lipper. Mutual Fund NAVs are as of previous day's close.
Earnings estimates provided by Zacks Investment Research.
Upgrades and downgrades provided by Briefing.com.
This material may not be published, broadcast, rewritten, or redistributed. © 2006 FOX News Network, LLC. All rights reserved. All market data delayed 20 minutes.