HMOs - Questions & Answers
Most Commonly Asked Questions
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 eyes.
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 a half-day's drive away and has 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 preexisting conditions?
A. Certainly, as long as they don't require any treatment.Q. What happens if I want to try alternative forms of medicine?
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 the 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 really perform a heart transplant right in his office?
A. Hard to say, but considering that all you're risking is the $15 co-payment, there's no harm in giving him a shot at it.