I found an optometrist that is cheaper than the ones my HMO plan covers, if they accept my insurance can I go there and will the HMO cover the cost?
2007-03-13 05:24:41 · 7 answers · asked by xtraluvly03 3 in Health ➔ Other - Health
Your insurance will not cover the cost if the doctor is not in their plan.
2007-03-13 05:28:40 · answer #1 · answered by Anita G 5 · 0⤊ 0⤋
any charges of your doctor that is not covered by your HMO will not be covered by your HMO... unless it was an emergency treatment (may still depend on your plan though)...
BUT: why would the optometrist accept ur insurance if they are not covered?
and why would cost matter if you are using your HMO anyway? don't worry how much your HMO will pay their accredited doctors -- that's the reason you have an HMO: so you dont have to worry so much about medical costs!
2007-03-13 12:35:34 · answer #2 · answered by schatz101 3 · 0⤊ 0⤋
Most HMO only cover a % portion of an out-of-network Dr or specialist. But there might be a small glimmer of hope because you can ask your Opt. or whoever to join the network. This is a very common thing. I had a Dr under my own insurance & when I got married we decided to use my husbands insurance primarily, she wasn't covered by his insurance so I asked her if there were any way she could join
she said she would look into it & her office sent me a letter the following week informing me of the changes and telling me to remember to bring my new card to my next visit!!
Good luck & God Bless
2007-03-13 12:53:26 · answer #3 · answered by ☆♥•´`•.¸ ;-) •´`•.¸ ♥☆ 4 · 0⤊ 0⤋
You answered your own question. If they are not on your HMO, then they are not going to cover it. You just said they aren't. Call them first and find out. You also said that they are cheaper than the ones on your HMO list. So go to them and pay less. You don't HAVE to sue your insurance if you find something cheaper.
2007-03-13 12:29:30 · answer #4 · answered by Anonymous · 0⤊ 0⤋
Yes and No.
Yes, you can still go there but no, they won't cover the cost at your HMO rate. They might pay a certain percentage (50% less your copay and less 'out of pocket', for example). Best thing to do is to call your HMO first--that way you wont have any nasty surprises.
2007-03-13 12:32:37 · answer #5 · answered by Munya Says: DUH! 7 · 0⤊ 0⤋
Your question is confusing, because if the optometrist is not one your HMO covers it means they wouldn't accept your insurance. Also, what you mean by "cheaper?"
2007-03-13 12:29:42 · answer #6 · answered by The Catalyst 4 · 0⤊ 0⤋
no they will not unless you have a referral. some plans may cover small percentage but go with the referral.
2007-03-13 14:30:50 · answer #7 · answered by Anonymous · 0⤊ 0⤋