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Do HMO health insurance plans allow native Americans to keep their PCP at a native clinic?

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Do HMO health insurance plans allow native Americans to keep their PCP at a native clinic?

I have established care at my local native health center and love my doctors there. i do not any have costs, except for things done outside the clinic such as labs, specialists, etc.

I also have an HMO insurance plan (not kaiser) through my job but I don’t use it… I prefer to see my doctor at the native clinic for everything.

I need to get some labs done and want to know if my insurance has to cover them if my doctor at the native clinic orders them. Usually a primary physician “ in network” has to order them. i also need a referral to a specialist. both the lab and specialist would be in-network with my Hmo plan. my hmo plan covers 100% labs and i would have a small copay for specialists.

I did have success with this once with one lab, but it was already cheap and i was willing to pay the full out of pocket if my insurance denied it. But the upcoming lab work is expensive without insurance and I wouldn’t want to be stuck paying full price

Maybe this seems like a trivial problem, but I don’t see the point of having to see another doc, fill out a bunch of paperwork, and pay a copayment, just to order lab work, and get referral. I want to keep all my care with my original doctor

There are laws that protect natives choices with healthcare, like ability to change plans every month, so im curious if there is something pertaining to my question that is similar

1 Reply 1

Re: Do HMO health insurance plans allow native Americans to keep their PCP at a native clinic?

I don't have a lot of experience with the regulations around protecting native rights. The best way to find out is to call the HMO directly and ask. It's possible that the services like the lab work and specialist would be covered by the plan regardless of who is ordering them.