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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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