Coping With Your HMO
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- Tell me exactly how you reward your doctors for cost containment. I want to be sure that your sytem won't keep me from having needed tests or seeing a specialist.
- Describe how you ensure that I will always be treated by a competent, well trained physician with no black marks on his/her records.
- Let me know up front who decides what is "medically necessary" in my case.
- Tell me how I can appeal a medical
decision that I don't think is correct, and tell me how
soon I will get your answer.
- Assure me that I will have free choice of physicians within your plan. Also, tell me who pays if I want to see a doctor outside your plan.
- Tell me what percentage of your revenue actually goes to treat patients as compared with marketing, administration and profit.
- Describe how you decide what drugs to provide to your patients. I need to be sure that I can get the best drugs for my particular medical condition. I have heard that generic drugs and other substitute drugs can be dangerously inadequate.
- Tell me how you decide when I get to see a specialist.
- Give you an easy way to know what I think about the quality of care your staff provides. Reward those who get high ratings.
- Describe to me how I will get prompt care in a medical emergency. Tell me whether you will charge me if I have to go outside your system.
HMO and Managed Care of Florida
Your Rights with an HMO
Fighting HMOs
