Dealing With an HMO

Discussion in 'Fibromyalgia Main Forum' started by Newswoman, Dec 9, 2002.

  1. Newswoman

    Newswoman New Member

    I live in Southwest Florida and will be dealing with an HMO for the first time. I was just diagnosed in April, so I don't know what this will mean for me with the fibro. I have always had PPO coverage. I'm a little nervous because I've only heard horror stories from people who had chronic illnesses and were using an HMO.

    I read the HMO's website, and I understand the PCP and the rest of it. However, I can't find any information on whether the HMO will cover altnerative treatments like massages. If you use an HMO, what has been your experience as a fibro patient?
  2. Newswoman

    Newswoman New Member

    I live in Southwest Florida and will be dealing with an HMO for the first time. I was just diagnosed in April, so I don't know what this will mean for me with the fibro. I have always had PPO coverage. I'm a little nervous because I've only heard horror stories from people who had chronic illnesses and were using an HMO.

    I read the HMO's website, and I understand the PCP and the rest of it. However, I can't find any information on whether the HMO will cover altnerative treatments like massages. If you use an HMO, what has been your experience as a fibro patient?
  3. pam_d

    pam_d New Member

    I never have had an HMO since getting FM--hopefully others can respond with their experiences. As a PPO subscriber, I do think I have more freedom to seek specialist care, and doctors are definitely allowed to spend more minutes with PPO patients. HOWEVER---many of the docs are the same, and a bad doc is a bad doc, regardless of HMO or PPO! I have yet to find a really good, comprehensive FM doc, and I have a PPO---so it's not a magic answer.

    Also wanted to say that much depends on the HMO. Years ago, before FM, I had an excellent HMO in CA. Had nothing but good experiences with it, was always refered to specialist care when needed & got timely appts. So, it really depends on the individual docs & HMO...

    Good luck with it!

    Hugs,
    Pam
  4. Newswoman

    Newswoman New Member

    I forgot to say its Blue Cross and Blue Shield of Florida.
    Sorry, it's one of those days.
  5. Mikie

    Mikie Moderator

    I'm a "group of one" and can choose any plan I want for myself. I chose the HMO because it is one of the best around. I have never had a problem with BC/BS. I have never asked for massages and I doubt any plan would pay for this unless it's in the context of physical therapy. BC/BS does pay for chiropracty and for adjustments by DO's.

    Love, Mikie
  6. Newswoman

    Newswoman New Member

    BC/BS, under its PPO, does pay for massages ...as long as its prescribed by a doctor. I can't remember how many per month, and what the limit is per year.