The HMO Health Care Companion: A Consumer's Guide to Managed Care Networks

Raymond stresses that HMOs are more than health insurance plans; they are, in fact, health care plans. But to protect and preserve one's health and get the most out of HMOs, it is important for subscribers to learn more about the plans' strengths and limitations. In easily understood language, Raymond outlines why HMOs have become popular, focusing on their health prevention and maintenance features, which include regular checkups and screenings. He also describes the ways HMOs contain costs, usually by limiting access to specialists without a recommendation from one's primary-care physician and avoiding many expensive medical procedures. Nonetheless, subscribers may disagree at times with their assigned HMO physician, and Raymond shows how to negotiate through the bureaucracy of an HMO in such cases. He also provides information on how to obtain good care from an HMO for such chronic problems as asthma, AIDS and diabetes. Although Raymond probably will not change the minds of anyone dead-set against HMOs or pleased with fee-for-service providers, he does furnish the information necessary for people who voluntarily elect HMO coverage or who must choose among them because an employer offers it. Look for a helpful glossary of managed care terms and a comprehensive resource directory of state HMO regulators. (Jan.)