Description of service
I pay $240 per month for an individual health plan with a large Southern California HMO. The plan allows for $10 prescriptions, $20 appointments, and $20 for lab work or x-rays. $100 for outpatient surgery, and I don't remember the fee for overnight stays. The emergency room fee is $100, but that's only if they don't admit you--I think they claim that they charge you for using the ER when it wasn't a real emergency).
Review of Service
I was born in and grew up with this HMO, so I'm very familiar with its workings. As a general rule, I have found that this kind of health care is excellent for normal health conditions. If you have anything that is easy to diagnose, then you will receive excellent and affordable care. Broken bones, stitches, strep throat...I have had all of these things and more, and received excellent care throughout.
On the other hand, if you have a condition or injury that is a little out of the ordinary, you may find that your doctors are not as helpful as they could be. Self-advocacy is an important trait in these situations.
I had one experience where the diagnosing nurse refused to listen to me, and misdiagnosed my condition--she gave me antibiotics for an ear infection, when there was actually a hole in my eardrum!
I took the initiative to make a second appointment, got the correct diagnosis, and the three procedures necessary to correct it.
Tips
As with any health insurance, make sure you understand what you are getting yourself into. Sometimes it is necessary to self advocate, but for most of the easy stuff, HMOs can be the best care for the best price.
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