Things to consider before
choosing an 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 Dr. Moe Howard 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 who
were participating 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 part of
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 that diploma from a small Caribbean
Island is very fresh.
Q. Do all diagnostic procedures require
pre-certification?
A. No. Only those you need.
Q. What are preexisting conditions?
A. This is a term used by the grammatically challenged when they
want to talk about existing conditions. Unfortunately, we appear
to be pre-stuck with 'pre and now' meaning the same.
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
$10 CO-payment, there is no harm giving him a shot at it.
Q. Will health care be any different in
the next century?
A. No. But if you call right now, you might get an appointment
by then.
Submitted by
Bill, Narberth,
Pa.