Do You Have An HMO?
Explaining American medicine
see
also
HMO Judgment Day
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.
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 $20 co-payment,
there's no harm in giving him a shot at it.
Q. Will health care be different in the next century?
A. No. But if you call right now, you might get an appointment by then.