Healthy Times

Term to Learn


Managed Care
Managed Care is a type of health insurance plan that offers members a choice of doctors and hospitals that participate within a network; these health care providers have agreed to care for members at reduced costs. Managed Care relies on the member's primary care provider (PCP) to coordinate care. Some plans may require referrals from a primary care provider to seek services from a specialist.

We offer several types of Managed Care plans, the most popular are:
  • HMO Blue: You work with a primary care provider who arranges your care and gives you referrals for specialist or hospital care within a network.

  • Access Blue: You work with a primary care provider for most of your care. You do not require a referral to seek care from a specialist within the network.

  • HMO Blue Options: Primary care providers and hospitals in the network are grouped into three levels (also called tiers). What you pay out of pocket for these providers is based on the tier level of the provider you choose for care.