If I see a doctor that isn't covered by my HMO plan will they still cover the cost?

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?

Your insurance will not cover the cost if the doctor is not in their plan.

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.

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?"

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.

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!

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

no they will not unless you have a referral. some plans may cover small percentage but go with the referral.

Tags

　　Hospice Care 　　Horner Syndrome 　　Hormones 　　Homosexuality 　　Homeopathy 　　Hodgkin Disease 　　HMO 　　Hives 　　HIV 　　Histoplasmosis 　　HIPAA 　　Hip Replacement 　　Hip Disorders

Related information

Is it better for me to get a HMO or PPO?

PPO if you can afford it. The difference is HMO is managed health care in which you must go to preselected (by insurance co.) providers and most provider list are very small in HMO. PPO you can u...

What is the difference between medicare and medicare hmo?

Medicare --and the different Medicare plans now on the market --can be very confusing. How you will be affected --whether you are enrolled in traditional Medicare or whether you are enrolled in one...

Are HMO Anti American and anti family? and possibly Nazi's in are own country?

Do what the corporations and sponsors do. Pay the talk show host to spout your opinion

...

HMO versus PPO?

HMO you have to choose a doctor, and anytime you need to see a specialist you have to see that doctor to get a referral. PPO you can go see any doctor within the plan, without referrals. Only...

If i have an HMO and i buy a supplemental insurance plan will the HMO refuse to pay?

How will the HMO know you have a supplemental plan? Generally, supplemental health insurance plans pick up where your primary plan leaves off. For example, if your HMO provides coverage for a ce...

HMO medical for family?

You should call or visit a local independent agent. This person works with all the big companies and can help you compare the hundreds of plans available. They don't charge you any extra for t...

HMO confusion?

All HMOs require referral. If you want to self-refer, you need a PPO.

...

Hmo ppo epo health plans how can i compare ? which one is good for me?how can i know to select for me?

health, I'm assuming that you've started a new job where you've come to the point where you must now choose a plan from all that's offered by your employee, or it's &quo...