SkinCare Physicians

Tips for using HMOs and essential facts

Published on Feb 21st, 2013 by Beth Hartigan

How to best use your HMOHMOs (health maintenance organizations) have a penetration rate of 34.5% in Massachusetts, the fourth highest in the United States, according to the Kaiser Family Foundation. Here at SkinCare Physicians, 43% of our patients are covered by an HMO insurance plan. This post explains the common characteristics of HMOs and offers valuable tips to ensure a worry-free visit at your specialist office.

What HMOs have in common

There are several different types of HMOs, but they all share the following few characteristics:

  • The role of the primary care physician (PCP): Members select a primary care physician (PCP) to coordinate all of their health care needs. Whenever you need to see a specialist you must go to your PCP first and obtain a referral. This can be a time consuming process, and you need to make sure your referral is at your specialty office prior to being seen. One huge advantage, if you have several health issues, is that your PCP is managing them for you and you can be certain you are pursuing the correct health care measures.
  • The HMO network: Members of HMOs are also confined to a list of physicians and hospitals that make up the HMO network.  If you select a specialist from this list you stay ‘in-network’ and, as long as you obtain your referral, your expenses are covered. If you wander off this list, you are considered ‘out of network’, and your expenses will not be covered.
  • The co-payment: There is a co-payment associated with HMOs.  The amount is usually listed on the insurance card and is paid at time of service.
  • The deductible: Depending on your HMO policy, your plan may have deductibles.  A deductible is a fixed amount of money you have to pay before you can enjoy the benefits of your policy.

Tips for using your HMO insurance

To smooth the process of seeing your specialist, such as your dermatologist at SkinCare Physicians, and have a worry-free visit, follow the simple tips below.
Valuable tips on how to use HMOs

  1. Be familiar with the rules of your HMO.
  2. Book, and keep, your annual PCP appointment.
  3. Update your demographic and insurance information with your PCP and Specialty office.
  4. Bring your card with you to all physician appointments.
  5. Make sure your HMO has the correct PCP name on your card.
  6. Allow your PCP 7 to 14 days to process your referral request.
  7. Call your specialty office prior to your visit to confirm they have received your referral.

HMO insurances can be confusing at first, but once you know how they work, visiting your doctor’s office is easy. For further advice on how to best prepare for your next visit at Skincare Physicians, go to our website.

Leave a Reply

Fields marked with * are required.

Back to top

Our Promise

Our team of renowned physicians and experienced support staff is committed to excellence in medical skin care and cosmetic procedures with a patient-centered focus for women and men in the greater Boston area and beyond.

Request a Consultation

So Long Double Chin, No Surgery Necessary

Introducing KYBELLA™, the only treatment proven to reduce a double chin with safe, simple injections.

Learn More

Contact Us

The form below should not be used by patients to communicate clinical questions to SkinCare Physicians. It is not a patient portal. If your message is of an urgent, clinical or confidential nature, please call us instead at 1-617-383-8201.


 Please email me news and special offers

 termsAccepted

captcha

Chestnut Hill, MA (617) 731-1600

SkinCare Physicians®
1244 Boylston Street (Route 9)
Chestnut Hill, Massachusetts 02467

Phone: (617) 731-1600 Fax: (617) 731-1601

Medical Website Design & Marketing
by Etna Interactive

SkinCare Physicians®
1244 Boylston Street (Route 9)
Chestnut Hill, Massachusetts 02467

Phone: (617) 731-1600 Fax: (617) 731-1601

Medical Website Design & Marketing by Etna Interactive

The dermatologists and other medical professionals at SkinCare Physicians specialize in a wide range of dermatology treatments and services, including laser hair removal, laser skin treatment, hair transplant, eyelid surgery, body contouring, psoriasis, skin cancer, BOTOX® Cosmetic, fillers, and Thermage®. From their offices in Chestnut Hill, they serve Boston, Brookline, Cambridge, Newton and Wellesley.