The Healthcare Industry of America; An investigative look at HMOs Essa

The wellnessc be effort of America An investigative look at HMOs Its no secret that health Maintenance Organizations, known as HMOs, have made healthcargon cheap for many Americans, but at what risks? Most employers offer some graphic symbol of health care plan that is an HMO. Lets face it, given the choice among indemnity coverage through your employer, in which he pays half the costs, or getting private redress coverage outside your employer, most Americans choose to go with employer-provided HMOs. Why then, has in that location been so much controversy with HMOs? An HMO is an physical composition whereby the subscriber, or patient, is allowed to choose a medical provider from a tend of doctors within a certain medical group. Each physician has subscribe a contract to see patients at a reduced rate. This guinea pig of plan does not allow the patient freedom to see and any doctor. All referrals to a doctor, other than the patients primary care physician, moldiness be ap proved by both that physician, and the insurance company. Most physicians pass on HMOs as a supplement to their practices. With HMOs, the patient has little or no co-payment depending on how the plan is set up. Most HMO co-payments range amid $5 to $15 dollars per office visit. The doctor, whitethorn receive half or less than half of his normal fee from the insurance companies. HMOs are characterized with the end to over or under treat patients. HMOs put limitations not sole(prenominal) if on the income of the provider, but besides on the compositors caseface of treatment that whitethorn be done. If a patient is in need of a specia inclination for a specific ailment, the insurance company has to review and approve a referral and deem it necessary. The process involves the patient going to his or her general practitioner, in like manner re... ...he pros. It helps immensely if you have the support of your primary care physician. If you have a hearing, find out how many peop le will be thither and make up a folder for each one.a). Contact topical anesthetic lawmakers, senators, representatives.b). Contact your State Insurance Commission in writing near your complaint. Send copies of correspondence in the midst of you and your HMO. Let the HMO know you are contacting your State Insurance Commission. Works Cited Evans, M. Stanton. If youre in an HMO, heres why. Consumers Research Magazine, Dec. 1997 p10(6). Sherrid, Pamela. Mismanaged Care. U.S. News & origination Report, Nov. 24, 1997 p57(3). Lowenberg, Stanley C. Hard Path to HMO reform. Los Angeles Times, Feb. 2, 1998 pB(4) col. 1. Figueroa, Liz. State Regulations of health care Reform. Los Angeles Times, March 4, 1998 pB(6) col. 4. The Healthcare labor of America An investigative look at HMOs EssaThe Healthcare Industry of America An investigative look at HMOs Its no secret that Health Maintenance Organizations, known as HMOs, have made healthcare inexpensive for many Americans, but at what risks? Most employers offer some type of health care plan that is an HMO. Lets face it, given the choice among insurance coverage through your employer, in which he pays half the costs, or acquiring private insurance coverage outside your employer, most Americans choose to go with employer-provided HMOs. Why then, has there been so much controversy with HMOs? An HMO is an governing whereby the subscriber, or patient, is allowed to choose a medical provider from a list of doctors within a certain medical group. Each physician has subscribe a contract to see patients at a reduced rate. This type of plan does not allow the patient freedom to see barely any doctor. All referrals to a doctor, other than the patients primary care physician, essential be approved by both that physician, and the insurance company. Most physicians adjoin HMOs as a supplement to their practices. With HMOs, the patient has little or no co-payment depending on how the plan is set up. Most HMO c o-payments range between $5 to $15 dollars per office visit. The doctor, may receive half or less than half of his normal fee from the insurance companies. HMOs are characterized with the aim to over or under treat patients. HMOs put limitations not only on the income of the provider, but also on the type of treatment that may be done. If a patient is in need of a specializer for a specific ailment, the insurance company has to review and approve a referral and deem it necessary. The process involves the patient going to his or her general practitioner, also re... ...he pros. It helps immensely if you have the support of your primary care physician. If you have a hearing, find out how many people will be there and make up a folder for each one.a). Contact local anaesthetic lawmakers, senators, representatives.b). Contact your State Insurance Commission in writing somewhat your complaint. Send copies of correspondence between you and your HMO. Let the HMO know you are contacting your State Insurance Commission. Works Cited Evans, M. Stanton. If youre in an HMO, heres why. Consumers Research Magazine, Dec. 1997 p10(6). Sherrid, Pamela. Mismanaged Care. U.S. News & humankind Report, Nov. 24, 1997 p57(3). Lowenberg, Stanley C. Hard Path to HMO reform. Los Angeles Times, Feb. 2, 1998 pB(4) col. 1. Figueroa, Liz. State Regulations of Healthcare Reform. Los Angeles Times, March 4, 1998 pB(6) col. 4.