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Re: Help I'm SOSMem

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Mem,

Look at your card or your policy from HR at your work.

It usually has 3 letters that follow the r

name ie Prucare PRU HMO or PRU PPO or PRU POS. This

tells them the type of policy restrictions you have.

An HMO is a capitated patient with the most restrictions

on their policy, PCP must give a refferal for any

hospital stay , ER visit or Surgery. Many times

they make you stay " in Network " for procedures. This

just

means you must go with certain DR's and Hospitals

they have contracts with.....UNLESS////////////////

//////////////////////////////////////////////////

what you want done can only be done by a certain

individual and you must have it done that way.

Then many times they will pay for Out Of Network

Dr's And Hospitals. Trust me Managed Care, is not

the boon everyone thought it would be.

Lv Judi in Fla

Quoting " Memory (am) " mem@...>:

> I am filling out the PI and have only gotten to the

insurance account type

> field. I am SOS! (stuck on stupid!) do they want

to know if I have an

> HMO

> or what? Please forgive my ignorance!

>

> Mem

>

>

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