Hip Talk Forum About Hip Resurfacing

Hip Resurfacing General Questions => Insurance Questions => Topic started by: 23109VC on March 04, 2022, 09:47:52 AM

Title: PPO coverage for seeing Dr Gross out of state?
Post by: 23109VC on March 04, 2022, 09:47:52 AM
Obviously I’m going to check with insurance companies but I thought I would just post here and see if anyone had any helpful information as well.

I currently have an HMO however I plan to see Dr. Gross for surgery next year and through my employer I am able to switch at the end of the year into another PPO plan my employer offers.  I work in public service and I have the option to change into a PPO plan administered by Blue Cross Blue Shield.

I am reading some information online that suggests that these plans may not be friendly to seeing out of state physicians?

Although when I go to the Blue Cross Blue Shield website and look up doctors under the plans of these PPOs Dr. Gross is a in network provider.

I’m curious if anyone knows if there are restrictions that even though he’s “in network” would  he  only be considered in network for people in South Carolina or for anyone in the USA under a BCBS plan??

I’d be traveling from California.  I’d be using Pers Gold or Pers Platinum
Title: Re: PPO coverage for seeing Dr Gross out of state?
Post by: jwall07 on March 04, 2022, 04:42:32 PM
My insurance was/is BCBS of NC Blue Options PPO. I had no issues at all with coverage. I had to pay certain fees up front but insurance reimbursed me fully. I figured they were happy to pay for outpatient surgery as opposed to a hospital stay! :)  You are in good hands. Good luck!
Title: Re: PPO coverage for seeing Dr Gross out of state?
Post by: LarryBud on March 05, 2022, 09:06:22 PM
He was " In network " for BCBS NJ.  You need to call the insurance company to know for sure.