Specialty Area: Managed Care
Questions That Should Be Asked:
- Where can I get a background on the doctors in the plan - both primary doctors and
- What hospitals are approved?
- Is vision and dental care included?
- What are the limits on prescription costs?
- Do you limit the medications that my doctor can use?
- What standards are used in covering emergency room care?
- Can my obstetrician be my primary care physician?
- If the plan is point of service, how do you determine the reasonable and customary 80%
- Are all pediatric specialists included?
- Is there pediatric emergency room coverage?
- What travel coverage is available in the plan other than emergency?
- Who decides if it is an emergency?
- Is the plan rated by certifying agencies?
- Does the physician gain by limiting testing, referral to specialist, or the use of