I offer health insurance to my employees through an HMO plan. Can my employees go to their HMO primary care physician instead of a workers’ compensation health network doctor?
A. Depends. If your employees have health insurance through a health maintenance organization (HMO) plan, your employees may select their primary care physician, who they selected prior to their injury, as their treating doctor for their workers’ compensation claim. However, your employee’s primary care physician must agree to follow all the terms and conditions of the workers’ compensation health network’s contract and comply with the Workers’ Compensation Health Care Network Act (Chapter 1305, Insurance Code) and applicable rules.
Related Questions
- If I am an employees primary care physician under his health insurance plan, can I serve as the employees treating doctor for a compensable injury?
- Can employees buy a Commonwealth Choice plan even if I offer employer-sponsored health insurance from another source?
- What if my employees want to designate their HMO primary care physician as their treating doctor?
