You may need to use services outside the plan if you can't get the care you need with the plan. If your health is at stake, financial constraints shouldn't keep you from doing what you must. Be a squeaky wheel. Complain to the HMO when you don't get a referral or an appointment that you think you need. If you're enrolled through your employer, complain to the benefits manager if you're unhappy with the plan.
Some employers have strong purchasing power.
Consumers Union's recommendations on how to choose a health plan are based on research originally conducted by Consumer Reports magazine and published in the August 1996 issue. Consumer Reports reported on survey data from more than 20,000 of its subscribers in HMO-type plans and more than 10,000 subscribers in Preferred Provider Organizations. Consumer Reports used information from the surveys to rate 37 of the nation's largest HMOs.