In fact, most managed care plans actually monitor your primary care doctor to make certain he or she does not over utilize the consultation process. The managed care plan may actually reward your doctor for a low rate of referrals. Some managed care plans have extensive participating hospital lists, while others have very limited hospital selections. Most uncommon medical conditions can be adequately cared for at many hospitals, but could be far better cared for at an institution with special expertise in that area. Managed care plans frequently prevent patients from transferring to these institutions of special expertise, as long as some, albeit lesser, care can be provided at their contracted hospitals.
Travel expenses are virtually always the responsibility of the patient.
Some plans also provide your primary doctor with a cash incentive based on how infrequently hospitalizations occur, how brief hospital stays are, how few consultations are recommended, or how few tests are ordered. My premiums keep going up and I have heard a new plan advertised that is offering much lower rates, without a deductible, and has no paperwork hassle. Insurance companies cannot provide you with unlimited, unrestricted access to physicians or hospitals of your choice, and still offer premiums below the going market rate. Cut rate insurance inevitably means cut rate coverage, cut rate service, and loss of free choice. Most typical HMOs function like large corporations, as they employ physicians, nurses and physician assistants full time, while excluding private practice physicians.