HMOs
Health Maintenance Organizations
In the United States, there are various forms of Health Insurance. One form is the HMO, where you must go to their doctors for healthcare. Frequently Asked Questions pertaining to HMO Plans:
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 Doctor Moe Howard, 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. Modern practice replaces the
physical finger poke with hi-tech equivalents such as voice mail and
referral slips, but the result remains the same.
Q. Do all diagnostic procedures require
pre-certification?
A. No. Only those you need.
Q. I just joined a new 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 at the time the information was gathered. 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!
Q. What are pre-existing conditions?
A. This is a phrase used by the grammatically challenged
when they want to talk about existing conditions. Unfortunately, we appear
to be pre-stuck with it.
Q. Well, can I get coverage for my pre-existing
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. I have an 80/20 plan with a $200 deductible and a $2,000 yearly cap. My insurer reimbursed the doctor for my outpatient surgery, but I'd already paid my bill. What should I do? A. You have two choices. Your doctor can sign the reimbursement check over to you, or you can ask him to invest the money for you in one of those great offers that only doctors and dentists hear about, like windmill farms or frog hatcheries.
Q. What should I do if I get sick while traveling?
A. Try sitting in a different part of the bus.
Q. No, I mean what if I'm away from home and I get
sick?
A. You really shouldn't do that. You'll have a hard time
seeing your primary care physician. It's best to wait until you return, and
then get sick.
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 the $10 CO-payment is
all you're risking, there's no harm in giving him a shot at it.
Q. What accounts for the largest portion of health
care costs?
A. Doctors trying to recoup their investment losses.
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."