Caroline-I didn't quite understand your question. Is this a work situation that is changing their coverage? If so, they usually have an open enrollment which covers all pre- existing situations. HMO's in general have not been a problem for us, in fact our out-of-pocket expense has decreased. I also have a Medical Flexible Spending Account through my Employer which helps. Deductions are made pre-tax and I am then reimbursed upon submission of receipts. Hope this helps!