Should I join an HMO?
Health Maintenance Organizations are profit driven companies concerned about the
bottom line and stockholders. HMO bureaucrats determine how much care you
should
receive, instead of your doctor.
- Much higher premiums than a Preferred Provider Organizations
(PPOs)
- There are no benefits outside of the network of
doctors.
- Only a doctor in the network can give you a
prescription
- Pre-existing conditions may not be
covered
- Your general
physician can only be changed monthly
- HMOs have less doctors in their
network
- You may not get a referral to a
specialist
- You may not get an appointment
right away
- You can't continue seeing the same doctor if you
change jobs or insurance companies
- You don't know if your (HMO) doctor's
medical
recommendations are being made entirely in your best
interest.
What is the alternative? Get a PPO quote from an indpendent insurance agent. Check our next page on HMOs versus PPOs.
Questions to ask about a health insurance plan:
With health insurance, it's imperative you enroll as soon as possible. Health problems and accidents develop out of nowhere, especially when you don't have coverage! If you are declined by a company because of health issues, only the state high risk fund or temporary health coverage may be available to you.
- Are there many doctors to choose from?
- Which doctors are accepting new patients?
- How hard is it to change doctors?
- How are referrals to specialists handled?
- Is it easy to get an appointment?
- How far in advance must routine visits be scheduled?
- How does the plan handle emergency care?
- What preventive services are provided?
- How convenient to your home and work are the facilities?
- How do you get medical treatment out of town?
- What are the annual premiums?
- What are the copayments for office visits, prescriptions, etc?
- What services are covered?
- Do they pay anything if you use a doctor outside the plan?
- Is there a deductible and coinsurance rate?
- Is there an annual maximum you pay out of pocket?
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