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Beth (Bethofvt) posted an update Thursday, Nov 17, 2011, 6:59pm EST, 13 years, 11 months ago
Nancy - Not all HMOs run the same way. Ours used to run like yours, but as of 2 years ago, we no longer need to get authorization to see a specialist as long as he/she is in our network. I pay a $15 copay if I see my primary care physician, $30 if I see a specialist. I know when I need a specialist just as well or better than my primary care doc does. Our insurance carrier finally agreed and realized that by requiring a patient to see the primary doc first to get referral, they ended up paying for TWO office visits instead of one. And they were right, after 2 years of doing it this way, it is not costing any more than it did the other way.