Medical Insurance Explained

Aug 12, 2007
2,128
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Minnesota
www.sonshineshelters.org
Medical Insurance Explained

MEDICAL INSURANCE EXPLAINED

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.


Q. Will health care be different in the next decade?
A. No, but if you call right now, you might get an
appointment by then.
 
Sep 4, 2007
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Texas
Ooooohhhh! Those are soooo true! :p


Sounds just like what I have gone through millions of times. I had to choose a plan. Okay, did that. Choose a doctor. I picked one. Then discovered that he is no longer even working at the clinic where I called, nor is he any longer accepting the plan where ever his new location was. I called back to tell the insurance provider that I needed to pick a new primary care doctor. They told me I wasn't in the system as having their plan and to call back the original number for selecting a plan. I called them back. They said I was in the system and to call back the other number I had just called prior. I called them back. Finally they found me. I chose a new primary care doctor.

My son got sick. I called the doctor. They had no room for that doctor to see him. Well, can he see a different doctor in the office? Normally yes, but since he had never yet seen the first then his first appointment must be with his primary. But the primary is full. "Call back Monday." My son has had fever of 104 for 3 days, he can not wait that many more days till Monday. Well, go to an after hour care facility that accepts the plan. Okay, where is one? They don't know. :rolleyes: Call back the insurance plan number..... where are the after hour care facilities? I need a nurse referral for that. A nurse calls me back. She agrees that he needs to see someone within 24 hours. Okay, who can he go see? She doesn't know, call back the insurance plan number. I call them back. Did I speak to a nurse? Yes, I just did that. What about his primary care provider? They won't see my child. Okay, then here is a phone number for an after hour clinic, but you will need to wait until they open at 5 pm. Thank you.

By the time you ever get help, you could be dead!!!!!!

And I have had so many times where I can not get the prescriptions I need. Sometimes there are NO substitutes either, and then I have to just purchase my own outright.