Questions You
Should Ask Your HMO
If you are thinking
of joining an HMO, call or write and ask the HMO to answer the
following questions. If you don't like the answers, discuss it
with your employer benefits administrator and perhaps reconsider
your decision to join.
1. Cost Containment
Do you provide any type
of financial incentive to any physician to limit diagnostic tests
or referrals to specialists?
2. Appeal
How can I appeal a medical decision
my physician and I think is wrong? How long will it take to get
an answer?
3. Choice of Physicians
What if I want to see a doctor
outside your plan; who pays? What if I want to switch doctors
within the plan?
4. Emergency Care
Would I be able to use the closest
medical facility in an emergency even if it is not in the plan?
5. Drugs
Will I be able to use medication
that have worked for me in the past? May my physician prescribe
drugs for me that are not on your approved drug list?
6. Access to Specialists
How do you decide when I get
to see a specialist? How long will I have to wait to get in?
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Contact ACHE at:
P.O.
Box 282 |
Helena, MT 59624 |
1-888-366-ACHE |
(406) 442-6629 |
Fax: (406) 442-6623 |
www.ache-montana.com |
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