This can be a problem in managed health care plans. Persons with disabilities enrolled in MCOs must educate themselves so that they can wisely choose the best health insurance plan and advocate for change in the system. In 1996, it was estimated that 100 million Americans were in managed health care plans. Many individuals with disabilities are included in this number. HMOs, or health maintenance organizations, provide health care services to their covered members.
Many individuals join HMOs through their employers or other groups.
They are paid a fixed fee per patient to take care of the covered members' health care needs. Usually patients are limited to choosing only HMO physicians. All health care services are tightly controlled by assigning patients to gatekeeper physicians who must approve all procedures, tests and referrals to other physicians. PPOs, or preferred provider organizations, are entities in which a group of physicians contracts with employers or health insurance carriers to provide health care services to covered persons on a discounted basis. Enrollees may have more flexibility in picking physicians than in HMOs.