Selecting the right health care plans and health care providers for yourself and your family is an important decision which requires careful planning and thought. If you or a family member has been diagnosed with a life-threatening illness, you need the peace of mind that comes with quality health protection.
You've heard the sayings before. Knowledge is confidence. What you don’t know could hurt you. Forewarned is forearmed. Look before you leap. These kernels of wisdom have never warranted more personal attention than in the era of managed care.
This section provides guidelines to selecting adequate health care protection as well as information on accessing specialized cancer care.
Managed care is a coordinated health care delivery system which provides comprehensive care to consumers; promotes disease prevention and healthy lifestyles; and determines the "appropriateness" of medical care, thus minimizing unnecessary costs.
Managed care organizations (MCOs) ensure over 60 million Americans. Even Medicare and Medicaid are converting to managed care systems as the most direct way to control costs and promote appropriate use of health care resources.
Managed care works best with routine medical cases – when diagnosis and treatment are "textbook," care is short-term, and outcomes are predictable. Chronic, life-threatening diseases, such as cancer or AIDS, all too often become the square pegs that must try to fit into the round holes of a changing health care environment.
Suppose you've just been diagnosed with cancer, and you belong to an MCO. You want to be referred to a cancer center, where health care professionals devote 100% of their worklife to studying, diagnosing, treating, and preventing cancer.
Ask yourself: In a managed care environment, will I be guaranteed access to the best care? Who will pay for the treatment? Are investigational treatments covered?
Unfortunately, most of us do not think about our health insurance until the need arises. Patients enrolled in managed care plans should be guaranteed the right to choose the appropriate specialist at the appropriate time. Without the protection of an adequate health insurance plan, however, there are no assurances.
The choices you make today can secure (or compromise) your family's medical and financial future tomorrow. Take a tip from the managed care adage: An ounce of prevention is worth a pound of cure. Select the right insurance protection now when you don't need it, so you don't have to worry when you do.