One horror story is about an HMO denying a patient's much - needed surgery. The patient had a serious medical condition that required immediate surgical intervention. But the HMO kept giving excuses, saying it was an 'experimental' procedure even though it was a standard treatment elsewhere. It took months of fighting and appealing before they finally agreed, by which time the patient's condition had worsened.
There was this case where an HMO changed a patient's doctor without any prior notice. The patient had been seeing the same doctor for years and had a great relationship. Suddenly, they were assigned to a new doctor who didn't have access to the patient's full medical history. This led to misdiagnosis and improper treatment, causing a lot of distress and a decline in the patient's health.