Keep in mind that you'll have to pay for any health care not covered by your plan. So, pick up on such details as whether the plan has a cap on the amount of care it will pay during your lifetime. Also, be aware of circumstances under which your plan will cover care from doctors or hospitals not associated with your plan. That's good information to have when you're traveling. It also helps to understand which of the many types of health plans you're in and how your particular plan operates.
Clear guidelines can result in high quality care.
You can help by asking your plan's member services department to explain the authority that doctors have to practice outside these guidelines if they think the case warrants. Your Rights Getting the most out of your managed care plan requires understanding your rights , which usually are listed in your plan documents. Note your right to appeal when treatment or payment is denied by the plan. Your plan may not give you a lot of details about your rights unless you ask. The member services department may be the only place to find out.