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[IP] Re: self-employed and health insurance help

If you use your primary care physician, you are using your HMO plan. If you 
don't use your primary care physician, i.e. go to other doctors in the health 
care network but not within your medical group and with a referral from you 
PCP, then you are using your PPO. I use a plan through Blue Cross called  POS 
(point of service) plan that allows you to do this, go back and forth between 
using an HMO and PPO format. It didn't take me all that long to reach my $500 
deductible because I use my PPO benefits for my endo. But I use my HMO 
benefits for pump supplies because they are 100 percent covered that way. All 
I had to do is see my PCP once and let him know that I see an endo under my 
PPO and I told him what supplies I needed. They forwarded that list to the 
medical group and my pump company communicates with them for an authorization 
when I order new supplies. This allows the HMO benefit.
I hope this is clear.
Good luck in your insurance shopping.
dxed T1 9/92, pumping since 1/02

In a message dated 1/2/03 3:39:27 PM, email @ redacted writes:

<< I'm really trying to figure out if the PPO plans work out better or worse. 
you don't use your primary care physician much, doesn't it take a long time to
get to a deductible on a PPO plan?  >>
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