The indemnity plan and managed care plans. Recently managed care has seen almost unprecedented growth in the US in response to the concerns about rising costs on the part of employers, the major purchasers of health care. Many people in the US are now enrolled in some type of managed care plan. In Wisconsin, the urban areas have very high penetration of managed care. The rural areas are just beginning to see managed care plans being offered.
Most plans are attempts to control health care costs through controlling access to services.
If you are insured through an indemnity plan, you can choose which physician you see, in what speciality, and how often. In a managed care plan, you almost always must see the gatekeeper. It is the gatekeeper who decides if you need a referral and to what kind of specialist. Some plans are experimenting now with allowing patients to self-refer. There are advantages and disadvantages to any type of health insurance.