Bought Based on Price

June 30, 2006 by bob.

Q. A few months back I purchased a group HMO plan from a well known carrier. Their price was significantly less than other carriers for similar benefits. Now I find the doctors in my area no longer accept patients who use this carrier. What do I do now?

A. You always get exactly what you pay for. That carrier has historical problems with their HMO and providers refuse to renew their contract. This happened a couple of years ago and many clients had to either pay out of pocket and see their regular doc or travel across town to see a different doc.

The plan you picked was about 30% below the other carriers. That should have been a clue that something was wrong.

The odds are good the HMO and the hospital (and docs) in that group practice will eventually make amends, but that may not happen for a couple of months. You can either pony up the additional premium and get a better plan with a different carrier; change plans with the same carrier but switch to a PPO at an even higher price and lesser benefits; or you can ride it out.

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