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My HMO dropped my specialist from its network. Don't I have any rights here?
You may have some rights, yes, but not necessarily extensive rights.
Some states laws to promote greater continuity of care. These laws require health plans to let certain people continue to be treated by their regular doctors after they're dropped from the network. The states that have continuity of care laws include Arkansas, California, Colorado, Delaware, District of Columbia, Florida, Illinois, Indiana, Iowa, Kansas, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Hampshire, New Jersey, North Carolina, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Vermont, Virginia, West Virginia, and Wisconsin, according to a March 2008 compendium by the National Conference of State Legislatures.
To find out if your state has passed a similar law, contact your state insurance department. Also read about your rights when your health plan changes.
Even if your state doesn't have such a law, you might have recourse through the HMO itself. Some health plans will allow you a specified number of visits to your former doctor, such as ob-gyns, neurologists and psychologists, when they are dropped from the network. Make sure you get pre-approval (in writing, if possible) from the HMO, lest you find yourself saddled with mounting bills that the health plan refuses to pay.
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