ANSWERS: 3
  • The biggest negative I have seen is that they try to stay within there own group to provide your care. If you need a specialists and they do not have one in their group, they may not refer you to someone outside their group until the condition/disease has gone far enough to cause permanent effects that could have been prevented.
  • Being denied treatment.
  • HMOs are more restrictive than other managed care providers. HMOs only cover members if they visit doctors within the HMO insurer network. If there's a specialist a member wants to see for a specific ailment and the physician is not in the HMO network, the member will have to pay out-of-pocket expenses.Also, since members have to initially establish a primary care physician, all medical treatments and referrals need to go through their PCP. Even if a specialist is in the HMO network, members still need to get approval from their PCP before they visit the specialist if they want to be covered by their HMO.But a health maintenance organization is still a practical solution for health care coverage. Monthly fees and co-payments are often minor and cover members regardless of how often they visit their physician each month. Source: http://www.bills.com/hmo-basics-article/

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