Questions for Your HMO

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What kind of durable medical equipment (DME) coverage will you receive?

Does the HMO pay for strips?

Does the HMO allow entrance into a diabetes clinic?

Are insulin pumps covered? If so, under what conditions?

Prevention is good business. Is this a prevention-oriented plan?

Does the HMO have a quality improvement committee for diabetes care?

Is the HMO trying to improve its diabetes care policies?

How often will you receive covered A1c tests?

What sort of diabetes education measures will you receive as a member of the HMO?

Does the HMO provide special diabetes education to its providers?

How does the HMO pay providers – is payment based on quality of care measures or utilization of resource measures?
Note: Not all HMOs will reveal this information. You want a plan that uses quality of care measures.

Is the HMO certified by the National Committee for Quality Assurance (NCQA)?
Note: The NCQA is a relatively new organization so if the HMO is not certified it does not necessarily mean that it provides poor services. But, if the HMO is certified it is a good indication that it offers quality coverage.

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