For all you Canadians out there..How is your medical care?
I think it is pretty good personally. I am a mother of three children. I am grateful they are pretty healthy. We do have a family doctor, but she works 2 hours away. We can always go to an afterhours clinic if we need to. That actually is quite a pain because the line-up waiting to get in it is huge and outside. When they finally unlock the door and let everyone in, they usually lock it up again and tell everyone else, sorry, it's full and the doctor can only see this many patients in the two hours the clinic is open. This is incredibly difficult for sick people and seniors and for parents with tiny children to have to be waiting outside in the winter weather for an hour or more to see a doctor. Now, I usually go to the emerg with the kids when it's bad weather so I can avoid this. But it's because there isn't enough doctors around for all the citizens. If we had more doctors the care would be easier to come by. The ones that are working are so stressed out and over worked. I really appreciate the ones that are still at it. The ones I've been to are great. I am happy that anyone here in Canada can see a doctor for free. That is good. You just may have to wait a while to see them.
What's the difference between HMO and PPO?
HMO stands for "heatlh maintenance organization". PPO stands for "preferred provider organization". With an HMO, you chose your PCP (personal care physician) from a network of physicians who have joined the HMO. For referrals, the PCP has to submit an authorization request to the HMO which approves (or denies) all referrals to specialists, all tests done outside the PCP's office and all elective hospitalizations and surgeries. Referrals are only to other physicians and hospitals who have signed up as providers for the HMO. A PPO does not require a referral. You can go to any physician, any specialist, any hospital whenever you want. Physicians who have signed agreements with the PPO plan will be paid according to the agreement rate. The patient will get a reduced patient share if they choose a physician who has a signed agreement with the plan. But if the patient chooses a physician or hospital not on the plan, the insurance will still pay but the patient share . (copayment) and/or deductible will be higher. Premiums are much lower for an HMO than for a PPO because the HMO has complete control over the patient's care. As far as precription coverage goes, HMOs have a list of approved drugs. Many also have an annual maximum for drug benefits which is often quite low (usually $600 to $1000 a year). PPOs may charge higher copays, but their annual drug maximum is significantly higher, sometimes no maximum at all. Bottom line, if you're rarely sick choose the HMO. If you need good coverage and can afford the deductibles and the copays, PPO will get you better care.