What Are the Disadvantages of Managed Care?
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What are some of the advantages and disadvantages of using managed care?

    Advantages:

    • Sometimes there is no deductible.
    • Your co-pay may be less than POS coverage.
    • A provider is chosen for you.

    Disadvantages:

    • Pre-approval is required before starting treatment.
    • You must tell an insurance company representative about your problem to be approved, no matter how embarassed you are to talk about it.
    • You are limited to panel or network providers, and sometimes have no choice at all. Often there are many more therapists with less training and experience.
    • Network providers may not be conveniently located.
    • Network providers may not have appointment times available that fit your schedule.
    • You may have to wait weeks for an appointment.
    • Network providers may not have expertise in treating your problem.
    • Network providers may have less education and experience than other local professionals.
    • There is limited confidentiality. The managed care company receives treatment summaries with details of your problem and treatment.
    • Treatment is usually more time-limited than in POS coverage.
    • You must receive authorization for all treatment.
    • The provider may be reluctant to ask for more treatment sessions because it is a "hassle."
    • Non-authorized or non-approved treatment will not be covered.
    • Type of treatment and length of treatment must be approved by managed care.
    • If you appeal managed care limits, coverage (and treatment) must wait for the appeal.

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