HMO Q & A

HMO Q & A

Date: Fri, 10 Oct 1997 17:12:12 +0600

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 a day's drive away.

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 - 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 - 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 till you return and then get sick.

Q - I think I need to see a specialist, but my doctor insists s/he can handle my problem. Can a general practitioner really perform a heart transplant right in his/her office? A - Hard to say, but considering that all you're risking is the $10 copayment, there's no harm in giving him/her a shot at it, eh?

Q - My insurer reimburses the doctor for my outpatient surgery, but I'd already paid my bill. What should I do? A - Your doctor can sign the reimbursement check over to you, or you can ask him/her to invest the money for you in one of those great offers doctors and dentists hear about, like windmill farms or frog hatcheries.

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.