As medicine becomes increasingly more advanced and complex, we are luckily able to save more people with more severe illnesses. But as a result, we have all seen an increase in the cost of providing this care and in purchasing health care insurance. Employers faced with the tasks of keeping a reasonable profit while responsibly maintaining health insurance coverage for their employees have sought new ideas to solve this problem. Most of what we hear now is the term 'Managed Care' or 'Health Maintenance Organizations'-called HMOs for short. We are participating members of several 'managed care' plans and several open staff HMOs.
It is important for you to make an informed decision as to exactly what you are receiving for health insurance benefits. Decisions you make go far beyond whether your child can continue with us for pediatric care, but can impact on which hospitals, and which specialty care you and your family are eligible to receive. Some plans have a record of not providing appropriate pediatric specialists when needed. Other plans might be overly restrictive in whether you can see a specialist at all. We find that plans that reward a physician for not seeing your child, or by overly limiting access to specialty care to be not in our or your interests.
Most larger employers offer a choice of two or three different
health
plans. We hope, of course, that you'll choose a plan in which we
participate.
But even if you choose a plan in which you must transfer your child's
pediatric
care elsewhere, we hope that you'll take the time to accurately assess
the pros and cons of your new health insurance plan. While high
deductible health plans may cost less and give some protection against
catastrophic expenses, you may have to pay the entire cost of the
office visits, procedures, and immunizations that can mount up very
quickly. We will not bear these costs for you; so be forwarned
that we do not consider these options appropriate for families with
young children.
For your reference, here's a list of those insurance plans In which we DO participate:
If after discussing the matter with our office manager and you feel that you have been treated unfairly by your health insurance plan, we suggest that you bring the matter up with your employee benefits manager at your work place. This person needs to know if the company's employees are dissatisfied with their health insurance plan.
IT CAN BE CONFUSING, SO IF YOU HAVE ANY QUESTIONS FOR US, PLEASE ASK.