How does Managed Care differ from Traditional Insurance?
Managed Care plans (HMO’s, PPO’s and POS) presuppose the use of a network of hospitals, physicians and other providers. These plans may or may not require referrals from a primary care physician. Those that require the use of a PCP are known as closed” or “gatekeepered” plans while those that allow direct access to specialists are known as “open access” plans. On the other hand, Traditional Insurance plans do not presuppose limited provider networks. They are in effect plans with complete freedom of choice of doctors, hospitals and other providers. Q: Is medical expense coverage available for substance abuse and mental illness? A: Yes. Coverage varies from state to state. In Connecticut, coverage for groups of 1 to 50 lives is mandated for mental illness and substance abuse. On an inpatient basis mental illness must be treated the same as any other illness for 60 days per member per calendar year. On an out patient basis mental illness must be covered at a level of 50% of the maximum a
The following will be addressed the week of 5/2, 5/7 Substance Abuse Policies Health Care proposals Child Welfare Assignments for the week of 5/2, 5/7 Read Chapter 10 Policy Based Profession P & L text Read Chapter 11 Policy Based Profession P & L text http://www.nga.org/Welfare/ASFA1997.htm Review of the Adoption and Safe Families Act of 1997 Read http://thomas, loc gov Then click on How or laws made under the Legislative process page.
