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I hate my HMO.
I have a serious problem which requires immediate surgery. I'll be fine - once I have the surgery! I live just outside NYC. There is ONE specialist in the whole county. I have to wait more than a week to see him. I tried their surgeons in Newark. Three of them do not answer their phone. The fourth cannot see me until the end of the month.
I went out of network today to a surgeon my pcp has worked with. He can do it Monday, and does not want to wait. His office will now spend all day on the phone with my HMO.
The HMO was no problem with scheduling ultrasound, but I needed a CT scan to be sure. Boyoboyoboy did they fight that. It was "in review". For two days. On the second day I called them up and told them they had the ultrasound, they were looking at the same thing my doctor was looking at, and even I could see I needed surgery so why were they playing stupid.
The words "lawyer" "do you intend for me to die waiting" and my pcps cell phone number got an instant approval.
I pay over 450 a month for an HMO in NJ as a self employed person. There are no group options for self employed in NJ. No AARP plans. No professional association or union plans. Just employer plans for companies of more than two people. And they are not cheap either.
There are no choices in NJ - just lawsuits.
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