No differences were found in self-reported unmet need by whether the individual was or was not enrolled in a managed care program. The rate of unmet need defined by no care was lower under managed care, but the rate defined by less or delayed care was higher. The effect was particularly pronounced in strong managed care programs, where the odds ratio of receiving delayed care or less care was twice that under unmanaged care (z=3.02, p<.001). In contrast, the odds ratio of receiving no care was only .61 in HMOs compared with traditional insurance plans (z=1.65, p<.10). Other comparisons suggest smaller differences in magnitude, but the direction is always the same: unmanaged care is associated with less unmet need due to less or delayed care and with more unmet need due to no care.