Getting the health care you deserve

Getting the best health care available takes work in the age of managed care. Don't settle for the least expensive HMO or the nearest doctor. Because managed care has such far-reaching influence, these tips also apply if you're covered by a traditional indemnity plan. Either way, here's how you can help ensure you get the best care for your money:

Compare health plans to your needs. Carefully read through health insurance policies to determine which plan will dovetail with your needs. While some HMOs have a long list of doctors to choose from, others limit you to a small network of physicians. Will the smaller network have all the doctors you need? You also have to consider any medical problems you may have, such as a heart condition or diabetes, that require visits to specialists.

Talk to friends and family about their health care choices. Before selecting an HMO or a primary-care physician, ask people you know if they can recommend a good HMO and a good doctor. Be sure to ask what they like or dislike about particular plans and physicians. Ask friends who work in the health care industry to recommend doctors who are respected and well-liked by colleagues and patients.

Interview doctors before you sign on with one. This gives you a chance to ask about each doctor's philosophy and approach. Again, think about what's important to you. Do you want to see the doctor for every visit, or will you be satisfied seeing a nurse practitioner? Do you want the doctor to explain every detail of a diagnosis, or just key facts?

Ask how each doctor gets paid to find out if it will impact your care or limit referrals to specialists. Also, notice how a doctor runs his or her office. Was the staff courteous? Was the office clean? Did the doctor see you on time? These details will give a glimpse of what to expect on future visits.

Don't ignore your gut reaction, either. If you're uncomfortable during an initial meeting, that doctor probably isn't the best one for you.

Learn to speak up. Because managed care is designed to cut costs by limiting doctor visits and procedures, there may be times when an HMO or your doctor says no to the second opinion, optional procedure or expensive test you want.

That's when it's important to advocate for yourself. Sometimes it's as easy as telling your doctor what you want. Other times you might have to fight with an HMO representative. In the worst case, you might have to file a complaint with the state attorney general to get what you want. To do so, call the AG's Regulated Industries Division at (617) 727-2200.