Medical insurance explained

360-hmoBy Larry McCormick

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 the pain in his foot if he was poked hard enough in the eye.

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. The 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 stomachache. 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/her office?

A. Hard to say, but considering that all you’re risking is the $20 co-payment, there’s no harm in giving it a shot.

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