Final answer:
Beneficiaries of managed care must usually use network providers and follow specific plan rules for their healthcare services to be covered, differentiating it from the fee-for-service system where providers are reimbursed per service rendered.
Step-by-step explanation:
If beneficiaries choose the managed care structure, they must typically select healthcare providers from within a network, receive referrals before seeing specialists, and follow the plan's rules for healthcare services to be covered. Managed care plans, such as Health Maintenance Organizations (HMOs), provide a preselected network of healthcare providers and emphasize preventive care. Within the context of healthcare financing, two primary structures are highlighted: a fee-for-service system and managed care.
In a fee-for-service system, providers are paid based on each service they perform, while in an HMO or other managed care plan, they receive compensation based on patient enrollment, with the task of managing and directing the patient's care within a set budget. Understanding these systems is key to recognizing the broader implications of health insurance markets, including concepts such as moral hazard and adverse selection.