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Step 1
Ask about which doctors you can see under the HMO. Most HMOs will only cover you if you go to certain physicians that they approve and appoint to be your Primary Care Physician (PCP). If you have another doctor in mind at the time of your medical needs, you'd have to check with the insurance company first to see if you'd still be covered.
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Step 2
Ask about benefits. You should find out everything that your HMO will cover. Find out if your prescriptions will be covered and what your co-pay will be for your check up doctor visits. Some programs have in network specialists that you can just go to, while others require you to get a referral before you can make an appointment, whether they're in network or not.
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Step 3
Ask about costs. Deductibles, co-pays and premiums are all costs to look at. You'll want to find out how much you'll end up paying for prescriptions if you get the brand names or generic. Find out how much you'll pay for hospital stays.
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Step 4
Ask about the HMO's service area. Many HMOs have specified regional areas that you aren't allowed to go outside of for service. You'll want to find out what area this covers and what kind of coverage (if any) you'll get if you travel outside this area.
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Step 5
Find out whether other members of the HMO are satisfied. Research studies and surveys regarding the particular HMO before you jump in. Find out how often customers leave this HMO for another and if there's as much customer satisfaction among patients with complex illnesses as among the average insured member.
