Difference between Medicare & managed care

With over 25 million Americans underinsured, there are many holes in health care coverage. Both managed care and Medicare will cover various expenses up to a certain point, and this is why it is important to understand the differences between both.

Medicare Features

Medicare is a government program that provides affordable health care coverage to those 65 years and older or who are disabled. There are three main components for Medicare these would include: Part A (hospital coverage), Part B (health care services) and Part D (prescription drugs).

Expenses

The overall costs for Medicare are almost nonexistent, where there could be no cost or a small fee for some medical services in extreme situations. There are no limitations on hospital stays, and Medicare processes all bills as well as claims.

Managed Care Features

Managed care is when the insurance company will establish relationships with different health care providers. They prepay for various services in the future. As someone is using these services, they share in what is known as co-pay or sharing the costs for these services with the insurance company.

Preventive Medicine

To keep costs low, managed care focuses on preventive medicine. This is where regular visits to physicians are used to prevent major illnesses such as stroke.

Considerations

Before working with Medicare or managed care plans, it is important to make sure there will be no holes in coverage, such as having hospital care covered yet having to pay for prescription drugs.

References

• Law Help
• Metro North Chamber
• Gov Monitor