My new HMO doctor will only refer me to a specialist within the clinic even though the specialist that I have been seeing for years is participating with my insurance company. What are my options?
You may not be allowed to go outside the clinic and have your medical bills covered. Tell your primary-care provider about all of your physical- and emotional-care needs, as he or she is responsible for arranging your health care while you are enrolled in the HMO or managed-care organization. If you are uncomfortable with your PCP or feel that she or he doesn’t listen to you, you may want to call the specialist’s office that has treated you to see which PCPs the specialist works with closely. Verify that the recommended provider is a participating provider in your HMO and see if he or she is accepting patients. Call your HMO and tell them you’ve switched PCPs.
