Medical Insurance Explained

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MelissaM

Well-known member
Joined
Jul 4, 2003
Messages
671
Location
Boulder, CO
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, and a diploma from a Third World country.

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.
 
HMO????

HMO????

I have never been in an HMO and didn't know exactly what it was, but my 6th sense made me very leery. Now that I've gotten the lowdown, I guess my senses were serving me well.

On the next to last question, it reminded me of my first experience with a cardioligist. Upon reading my echo report my G.P. referred me to a cardiologist. At the appointment, he hit me right between the eyes with "You need to have your valve replaced, that means open-heart surgery". WHAT? "Get it done and get it over with and get on with your life". My reply was I will have to do a lot of thinking about this.
When I next met with my G.P. he asked how it went. I told him what he said and then I SAID " He seemed so eager that I think he must have had a van outside with a portable operating room and was waiting for me to say O.K." My G.P. just smiled and said I'll get you an appointment with another cardiologist.:(

That was 2 years ago:D
 
LOL!

I like this one....partly because it is ssssoo (sadly) true...and partly because it is equally as funny....

Seriously, tho, I've never been part of an HMO. I've always opted for the PPO, basically because that's the only way to have all of my main doctors (PCP, cardiologist, etc.) in the same plan. I also choose it because it gives me the opportunity to "out of network" (albeit with less coverage), if needed.

But...arg...my medical plan is changing for next year, going from a flat $20 co-pay for doctor visits, to a co-insurance plan, whereby I'll be paying a percentage of the entire bill up front. Arg. This is not going to be good for anyone with a "chronic" illness....more punishment :(.

Peace...Always,
Cort S, pig's valve & pacemaker-enhanced 30/swm
AIM=fc72mc ... YIM=knightfan2691
member & newsletter editor, Faith COB: http://www.faithcob.org
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RIP: '76=Parents' [my] MC ... '88 MC LS ... '00 "mc" LS
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