Choosing
an HMO
Choosing
an HMO is probably the most important thing to do.
What things should I think
about before choosing my HMO?
When choosing a health plan
make sure it offers the services that you and your family need. You should
ask friends, family and the Enrollment Specialist (800-291-2002) some questions
before choosing a health plan. The box below gives some questions you should
ask:
-
Is my family doctor in the HMO?
-
Is the clinic, hospital or pharmacy
I use a part of the HMO?
-
Is my dentist, eye doctor or
counselor in the HMO?
-
Where are the HMO hospitals
and doctors located?
-
What are the office hours of
the HMO doctors?
-
Does the HMO offer any special
services that Medicaid does not?
-
Are there persons who can speak
my language in the HMO?
-
If I am disabled, can I easily
get services at the clinic, doctor’s office or hospital?
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How do I sign up for
an HMO?
Once you have Medicaid:
You will get papers to sign
up for an HMO.
You will be given about six
weeks to sign up. Until you sign up for an HMO you can see any Medicaid
provider.
When you are officially enrolled
in your HMO you will have to see the providers in your HMO.
What happens if I don’t sign
up within the time given?
If you do not sign up within
about six weeks, the state will assign you to an HMO. If this happens you
have three months to change to another HMO. If you do not change during
this time you will be “locked” into that HMO for nine more months, for
a total of 12 months in the same HMO.
You can only change if you can show that you have a good reason for
not being in an HMO. (For example: if you have a disabled child who is
receiving SSI whose specialist is in a clinic which is not part of a Medicaid-HMO
and it is difficult for you to take the rest of your family to a different
clinic.)
