Quote Originally Posted by Edwina's Secretary View Post
This is not necessarily true. In many HMOs if you do not like your doctor or the service you receive the only way to change (at least until the next open enrollment) is if you want to pay the whole thing on your own (and who can afford to do that??) I had an employee recently who needed to see a specialist but her HMO could not schedule her for weeks.

Most plans today are HMO or PPO - in an HMO you do not have coverage unless you do to the designated doctors/clinic/hospital. In a PPO you can go to other than the designated but your benefits will be reduced (often sharply.)

And doctors go in and out of plans. In Chicago we had a doctor we liked very much. His hospital decided not to stay in the plan we had. We either had to change doctors or switch to a lesser plan in order to continue to see him.
Yes - that's true. But you do have the option to go out of network.

Another thing that I find rather ludicrous, is what doctors are "allowed" to charge. I'm now on Medicare and supplemental insurance, and I questioned a recent bill for a routine follow-up visit with my primary care doc. I was charged $122 for a simple office visit, yet a sign in the reception area stated that rates were now $70 for the same. When I called the billing dept to question it, she told me that he charges me what Medicare "allows", and that the $70 was for cash patients with no insurance. So the government is allowing doctors to cause rates to be high. What's wrong with that picture??? Fortunately my supplemental picks up what Medicare doesn't pay, or I couldn't afford to go to a doctor either!