Preventive care — HMOs pay for programs aimed at keeping you healthy (yearly checkups, gym memberships, etc.) so they won't have to pay for more costly services when you get sick.
Lower premiums — Because they limit which doctors you can see and when you can see them, HMOs can charge lower premiums.
Prescriptions — As part of their preventive approach, HMOs cover most prescriptions for a co-payment that can be as low as $2.
Fewer unnecessary procedures — HMOs give doctors financial incentives to provide only necessary care, so doctors are less likely to order tests or operations you don't need.
Limited paperwork — While doctors and hospitals have more paperwork under managed care, HMO members usually only have to show their membership card and pay a $5 to $10 co-payment.
Limited doctor pool — To keep costs down, HMOs tell you which doctors you can see, including specialists.
Restricted coverage — You can't expect treatment on demand because your primary-care physician must justify the need based on what benefits your plan covers.
Prior approval needed — If you want to see a specialist or go to the emergency room, you need permission from your primary-care physician.
Possibility of undertreatment — Because HMOs give doctors financial incentives to limit care, your doctor may try to skimp on the treatment he gives you.
Compromised privacy — HMOs use patient records to monitor doctors' performance and efficiency, so details of your medical history will be seen by other people.
© Copyright 1997 Essex County Newspapers