The following information may help you obtain optimal care if you happen to be enrolled in a HMO or other kind of managed care program.

    Many individuals are enrolled in a HMO or other kinds of managed care programs where choice of which physician / hospital you go to could be limited. In many instances prior referral from the plan's approved primary care doctor is needed before one can see an outside provider.
    If you happen to be one of those few whose health problems are not getting better and you want to see a provider outside your plan, then talk about this frankly with your plan's primary care M.D.
    In many instances, communicating with your plan's primary care M.D. in writing as to what exact health problems you are suffering and why you are requesting referral to a certain provider may help.

If things are still not working to your satisfaction, then requesting forreferral denial in writing and seeking help from your employer, State'sInsurance Commissioner's office or your own legal counsel may be theonly options left.

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