Question:
Where can I go with my HMO?

I am trying map out plan of attack here, I have seen my pcp. He said if I dont have this done, I will die. He gave me some info on bariatric treatment centers. They, or no one else will talk to me because I have an H.M.O.(humana choice care.) I dont know were to turn from here.    — Jay Z. (posted on January 2, 2002)


January 2, 2002
Start researching doctors in your area. Go to the find a doc section of this site and look at doctors in your area. When you read about them it tells you known providers (although you will have to call the doctors office to find out all the insurances they accept). You can see if someone had surgery through them and had an hmo. Keep searching and good luck! p.s. if you can't find someone in your area you may have to travel, alot of surgeons take patients who need to travel.
   — [Anonymous]

January 2, 2002
If you have the HMO through your employer or your spouse's employer, contact the Human Resources department. They should have a copy of the policy and you should be able to get it. Also call the HMO. You do have a right to know what's in the policy. Good Luck!
   — [Anonymous]

January 2, 2002
If you are in an HMO, you will probably need an actual referral from your PCP to the surgeon you want to see. In researching this myself, I found a list of surgeons in my area, then did a cross search on my HMO website to find one in my medical group, and then told my PCP who to write the referral to.
   — kateseidel

January 2, 2002
Jay, I have Blue Cross/Blue Shield Horizon HMO...I was worried that they wouldn't approve my WLS, but they did without a bit of trouble and in only 4 days! I couldnt have been happier. The only hassle was I had to get referrals from my pcp for EVERYTHING, but thats a small price to pay. My pcp was so supportive of my surgery, as was his office staff. So I actually enjoyed our mini-visits when I would go in to pick up the referrals. Don't give up hope!
   — Donna L.

January 2, 2002
I have Humanna HMO and did not have any problems at all. You have to get a referal from your PCP. Did you read in your policy if WLS is covered or not. Good Luck. Surgery 6-4-01 down 108 lbs
   — KAREN T.

January 2, 2002
I also used this website to find bariatric doctors in my area. Then I found out which ones were included in my HMO. I then asked my PCP to write a referral to that particular surgeon. (Actually ended up with a second referral to another surgeon in the HMO network who did lap). No problems at all. You might way to try looking up others' experiences with Humana in the insurance section of this site.
   — Kathy J.

January 2, 2002
Hi Jay: I had Pacific Care HMO and I HAD to go through my PCP for a referral to a bariatric surgeon within my group. Fortunately, the surgeon I had chosen, WAS within my med group....but with an HMO I had no other choice other than the referral from my PCP...GOOD LUCK !!!!
   — Joi G.




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