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Featured

Featured
13 qualifying life events that trigger ACA special enrollment
Outside of open enrollment, a special enrollment period allows you to enroll in an ACA-compliant plan (on or off-exchange) if you experience a qualifying life event.

Latest News & Topics

Latest News & Topics

Featured

Featured
Finalized federal rule reduces total duration of short-term health plans to 4 months
A finalized federal rule will impose new nationwide duration limits on short-term limited duration insurance (STLDI) plans. The rule – which applies to plans sold or issued on or after September 1, 2024 – will limit STLDI plans to three-month terms, and to total duration – including renewals – of no more than four months.
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managed care

What is managed care?

healthinsurance.org health insurance glossary

A medical delivery system that attempts to manage the quality and cost of medical services that individuals receive. Most managed care systems utilize an HMO, EPO, PPO, or POS network design, limiting to varying degrees the number of providers from which a patient can choose, whether the patient has to use a primary care physician, and whether out-of-network care is covered under the plan. Some managed care plans attempt to improve health quality, by emphasizing the prevention of disease.

Indemnity plans were popular before the advent of modern managed care plans, but they have been largely replaced by managed care plans over the last few decades, and the vast majority of privately insured Americans are in some form of managed care plan.

Even in the Medicaid and Medicare systems, managed care is playing an increasingly large role: More than two-thirds of the people enrolled in Medicaid were covered under private Medicaid managed care plans as of 2017. And 34 percent of Medicare beneficiaries were enrolled in private Medicare Advantage plans in 2019 — a percentage that has been steadily growing over the past decade.

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