…. it’s great to hear results.
Although we’ve yet to meet in person, I’ve known Bob and his wife Signe for several years and we stay in touch through telephone calls and social media. Signe went online and wrote about their frustration in getting the HMO referral and approval for Bob to receive treatment outside of the North Carolina HMO network.
A Common HMO Rule: If you need treatment from a specialist, such as a cardiologist or dermatologist, or if you require lab work or diagnostic tests like x-rays, your primary care physician will have to provide you with a referral. If you do not get a referral from your PCP or if you use the services of other health care providers outside of your HMO’s network, the visit may not be covered under your plan and you may be required to pay for all or most of the services.
I responded with a quick note explaining how Bob, with Original Medicare alongside a Medicare Supplement (aka MediGap) plan, could seek treatment from any provider or facility in the United States. No referral would be required and no stress over whether the provider or treatment center is in or out of the HMO network.
Bob chose to enroll directly in an AARP Medicare Supplement plan insured by UnitedHealthcare Insurance Company. And, as Bob’s note indicates, he chose Medicare Supplement Plan N which includes a $20 office visit copay. A year later, I’m delighted to report my friend Bob is doing well. And he is quite pleased to have been able to choose where he received his treatment without added expense and stress. (And, I might add, Bob has been impersonating Mark Twain for audiences since 2009. Enjoy this clip.)