Your Health Maintenance Organization
A Managed Care Insurance Plan
- Frequently Asked Questions About Your HMO
Q. WHAT DOES HMO STAND FOR?
A. This is actually a variation of the phrase, "HEY MOE". Its roots go back to a concept pioneered by Moe of "The Three Stooges", who discovered that a patient could be made to forget about the pain in his foot if he was poked hard enough in the eye.
Q. I JUST JOINED AN HMO. HOW DIFFICULT WILL IT BE TO CHOOSE THE DOCTOR I WANT?
A. Just slightly more difficult than choosing your parents. Your insurer will provide you with a book listing all the doctors in the plan. These doctors basically fall into two categories -- those who are no longer accepting new patients, and those who will see you, but are no longer participating in the plan. But, don't worry, the remaining doctor who is still in the plan and accepting new patients has an office just half-a-day's drive away, and a diploma from a third world country.
Q. DO ALL DIAGNOSTIC PROCEDURES REQUIRE PRE-CERTIFICATION?
A. No, only those you need.
Q. CAN I GET COVERAGE FOR MY PRE-EXISTING CONDITIONS?
A. Certainly, as long as they don't require any treatment
Q. WHAT HAPPENS IF I WANT TO TRY ALTERNATIVE FORMS
A. You'll need to find alternative forms of payment.
Q. MY PHARMACY PLAN ONLY COVERS GENERIC DRUGS, BUT I NEED THE NAME BRAND. I TRIED GENERIC MEDICATION, BUT IT GAVE ME A STOMACH ACHE. WHAT SHOULD I DO?
A. Poke yourself in the eye.
Q. WHAT IF I'M AWAY FROM HOME AND I GET SICK?
A. You really shouldn't do that!
Q. I THINK I NEED TO SEE A SPECIALIST, BUT MY DOCTOR INSISTS HE CAN HANDLE MY PROBLEM. CAN A GENERAL PRACTITIONER (OR HIS PHYSICIAN'S ASSISTANT, IF HE'S NOT FREE) REALLY PERFORM A HEART TRANSPLANT RIGHT IN HIS OFFICE?
A. Hard to say, but considering that all you're risking is the $20 co-payment, there's no harm in giving it a shot
Q. WILL HEALTH CARE BE DIFFERENT IN THE NEXT CENTURY?
A. No, but if you call right now, you might be able to get an appointment by then.
Helpful Charts To Answer Your Questions
- The HMO Philosophy
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