Will HMOs pay for medical treatment for fibromyalgia?

If you are a member of a managed health care organization, such as a Health Maintenance Organization (HMO), you may face additional challenges when seeking proper diagnosis and treatment of fibromyalgia. If your physician is “capitated,” he or she is financially rewarded by the insurance company for ordering fewer tests and services. This is bad news for fibromyalgia patients, because extensive tests are often required to diagnose and treat the condition.

In addition, many HMOs have confidentiality clauses in their contracts that prohibit physicians from saying anything that could harm the patient’s confidence in the HMO’s policies and coverage. Doctors may be under a formal or informal gag rule that does not allow them to discuss any treatment options not covered by your HMO. You may want to correspond with your HMO in writing, and make sure to get a written reply before going ahead with medical treatment. Make sure that you have a doctor whom you feel confident will act in your best interest.

Return to: Fibromyalgia and Benefits or view one of the following: When was Fibromyalgia first identified? What are the physical symptoms of Fibromyalgia ? What is Guaifenesin ? What factors may aggravate fibrofog ? What medications are used to treat fibromyalgia ? What causes fibromyalgia ? What other health conditions are associated with fibromyalgia ? Fibromyalgia and Social Security Disability and SSI Benefits What is fibromyalgia syndrome (FMS) ? How can fibromyalgia patients improve sleep quality? Are there other areas for tender points ?