How to Avoid HMO Traps
Health insurance is hard to understand, especially HMOs (Health Maintenance Organizations). With all the rules of what benefits you do or don't have, what doctors you can and can't see and how much things cost, it's easy to get confused. There are even shady agents out to make a quick buck from your confusion. Don't let yourself fall into the traps.
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Instructions
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Suspect shady dealings. Most agents are truthful, helpful and upfront. There are some, however, who want to get rich off of your misunderstanding of HMO procedures.
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Watch out for signs of a scam. You should get your policy within six weeks. You should get annual reports. You're policy should only have the coverage that you asked for--nothing less and nothing more. You should get receipts every time you make a payment. If you're not getting all of these, find out why.
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Read and understand everything regarding your HMO. Read all documents, including the fine print. If there is something you have a question about or do not understand, you do not have to sign. Make the agent explain in detail anything you don't understand.
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Put it in writing. If you ever have a dispute against your HMO company, you should communicate it in writing via mail. Whether you think you were denied coverage wrongfully or you want to argue a bill, write it down and mail it in. You can ask on the phone, but you could easily be given misinformation over the phone and then you have no proof of what you were told. Written documents are legally binding.
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Save all HMO documents. Anything you are given by the company (invoices, receipts or letters) should be kept and saved. You never want the company to make a claim that they sent you something if they didn't. Keep everything.
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Tips & Warnings
Don't get suckered in. Avoid agents who pressure you to sign up for insurance with them and fast. You have plenty of time to shop around and make decisions, so don't let yourself be rushed. Don't sign any deals that don't have the full contract filled in and don't sign for any deal if the agent says you have to pay in cash or money order.
