Gatekeeper - Health Insurance Definition
The Gatekeeper is the person who
coordinates your care when you carry a managed
care plan. Your gatekeeper will most often
by your personal physician but the duties could
also be filled by a person hired by the insurance
company. The gatekeepers duties are to be the
first person of contact for questions about your
health care needs. That person also approves referrals
to specialists.
Before you decide that you don’t want anyone
making those decisions and having that kind of
power over you, consider this: If your primary
physician told you that you should see Dr. X for
a particular complaint, would you follow that
advice? If you already trust your doctor to make
the right suggestions, it’s a small step
to trusting him or her to be your gatekeeper.
But before you decide that having a gatekeeper
is acceptable, consider that you may not always
have control over the person who serves as gatekeeper.
Within a managed care plan, you are subject to
the rules of the company providing the service. |
