quick question

Nurses General Nursing


  • by Whisper
    Specializes in Cardiolgy.

Can any please tell me what HMO stands for? I am reading a US book on cancer care, and it mentions HMO offer less options, and choices with things like wigs and some treatment options.

Any help would be fantastic.


Nurse Ratched, RN

2,149 Posts

Specializes in Geriatrics/Oncology/Psych/College Health.

Health Maintenance Organization (another form of insurance company organization.)


597 Posts

Specializes in Cardiolgy.



1,010 Posts

Specializes in ER CCU MICU SICU LTC/SNF.

And here's why we Americans are very careful in choosing one:

Frequently Asked Questions About Health Care

Q. What does HMO stand for?

A. This is actually a variation of the phrase, "Hey, Moe!" Its roots go back to a concept pioneered by Doctor Moe Howard, who discovered that a patient could be made to forget about the pain in his foot if he was poked hard enough in the eyes. Modern practice replaces the physical finger poke with hi-tech equivalents such as voice mail and referral slips, but the result remains the same.

Q. Do all diagnostic procedures require pre-certification?

A. No. Only those you need.

Q. I just joined a new HMO. How difficult will it be to choose the doctor I want?

A. Just slightly more difficult than choosing your parents. Your insurer will provide you with a book listing all the doctors who were participating in the plan at the time the information was gathered. These doctors basically fall into two categories: those who are no longer accepting new patients, and those who will see you but are no longer part of the plan. But don't worry; the remaining doctor who is still in the plan and accepting new patients has an office just a half day's drive away!

Q. What are pre-existing conditions?

A. This is a term used by the grammatically challenged when they want to talk about existing conditions. Unfortunately, we appear to be pre-stuck with it.

Q. Well, can I get coverage for my pre-existing conditions?

A. Certainly, as long as they don't require any treatment.

Q. What happens if I want to try alternative forms of medicine?

A. You'll need to find alternative forms of payment.

Q. My pharmacy plan only covers generic drugs, but I need the name brand. I tried the generic medication, but it gave me a stomach ache. What should I do?

A. Poke yourself in the eye.

Q. I have an 80/20 plan with a $200 deductible and a $2,000 yearly cap. My insurer reimbursed the doctor for my out-patient surgery, but I'd already paid my bill. What should I do?

A. You have two choices. Your doctor can sign the reimbursement check over to you, or you can ask him to invest the money for you in one of those great offers that only doctors and dentists hear about, like windmill farms or frog hatcheries.

Q. What should I do if I get sick while traveling?

A. Try sitting in a different part of the bus.

Q. No, I mean what if I'm away from home and I get sick?

A. You really shouldn't do that. You'll have a hard time seeing your primary care physician. It's best to wait until you return, and then get sick.

Q. I think I need to see a specialist, but my doctor insists he can handle my problem. Can a general practitioner really perform a heart transplant right in his office?

A. Hard to say, but considering that all you're risking is the $10 co-payment, there's no harm giving him a shot at it.

Q. What accounts for the largest portion of health care costs?

A. Doctors trying to recoup their investment losses, like windmill farms or frog hatcheries.

Q. Will health care be any different in the next century?

A. No, but if you call right now, you might get an appointment by then!


799 Posts

Specializes in Step down, ICU, ER, PACU, Amb. Surg.

BWWWAAAHAHAhahahahahahaha!!!! :rotfl: :rotfl: :rotfl:

Talino.....too funny and yet too close to home. HMOs are touchy critters and they do not like to pay for prevenitive treatment and screening tests....they would much rather pay for pallative Tx and claim a profit when you die (cold but the harsh reality and I actually had Blue Cross/Blue Shield's Blue Choice HMO admit that to me via telephone) Then tell them you need preauthorization for the doctor you have been seeing for months (a specialist) to do a surgical procedure in a hospital that take your insurance but when he is in that facility, he doesn't and you get the approval after your time for the OR has come and you can't go in cause you do not have the authorization for the doc to touch you....but that authorization comes after you leave the hospital and get 15 minutes down the highway on your 2 hour drive back home....then have to reschedule and scream and jump up and down to get the authorization before the next surgery date. GRrrrrrrr :( Or take a medication for over 3 years to be told that they will no longer pay for the drug with out prior pre approval, causing you to have to waste time writing a letter, forward that letter to them as well as your GP, making him write a letter divulging your entire medical Hx and waiting a month, causing your GP to give you an entire box of samples from the office to get the approval to get the drug 1 day before all your samples are gone! The hike up premiums and take benefits away......a shame to the companies that actually tried but no longer are there for the choosing :(

The doctors don't fare much better either. Takes months and years to be paid for services and then at discount rates. The ones who stay in HMO's are sometimes viewed by other MDs as "losers" who cannot get patients any other way. Really a mess.

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