Subject: HMO info
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:
1) Those who are no longer accepting new patients, and
2) 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
Q. Well, can I get coverage for my pre-existing conditions?
A. Certainly, as long as they don't require any
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 stomachache.
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
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 all you're out is the $10
co-payment, there's no harm giving him a shot at it.
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